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Individual

DR. JACOB COLE JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
525 E 68TH ST, BOX 124, NEW YORK, NY 10065-4870
(212) 746-2959
(212) 746-8563
Mailing address
525 E 68TH ST, BOX 124, NEW YORK, NY 10065-4870

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
25MA10388000
NJ
207L00000X
Anesthesiology Physician
Primary
288525
NY

Other

Enumeration date
04/01/2013
Last updated
06/12/2025
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