Individual
DR. ADELSO TEJADA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 GUSTAVE L LEVY PL # 1259, NEW YORK, NY 10029-6504
(829) 281-0159
Mailing address
1 GUSTAVE L LEVY PL # 1259, NEW YORK, NY 10029-6504
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/03/2020
Last updated
04/06/2020
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