Individual
ANNA DELL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4057 PAULDING AVE PH, BRONX, NY 10466-4705
(646) 387-1559
Mailing address
4057 PAULDING AVE, BRONX, NY 10466-4705
(646) 387-1559
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
303610-1
NY
Other
Enumeration date
11/23/2010
Last updated
01/22/2019
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