Organization
MJ NP IN FAMILY HEALTH CARE P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE ANN JACKSON FNP (FNP)
(631) 394-5310
Entity
Organization
Contact information
Practice address
163 POOSPATUCK LN, MASTIC, NY 11950-5201
(631) 394-5310
Mailing address
PO BOX 273, MASTIC, NY 11950-0273
(631) 394-5310
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
04/13/2020
Last updated
04/13/2020
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