Individual
MRS. EDITH J. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1414 MAIN AVE, CLIFTON, NJ 07011-2157
(973) 253-6000
Mailing address
19 CIDER MILL RD, HAWTHORNE, NJ 07506-3001
(973) 253-6000
(973) 253-6009
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00415600
NJ
Other
Enumeration date
01/29/2013
Last updated
09/19/2018
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