Individual
CAMEILA LORETTA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
851 E 228TH ST APT 2, BRONX, NY 10466-4454
(917) 497-8523
Mailing address
851 E 228TH ST APT 2, BRONX, NY 10466-4454
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
599654
NY
Other
Enumeration date
07/14/2023
Last updated
07/14/2023
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