Individual
TAMIKO V JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1423 CHAPEL ST, UNIT B, NEW HAVEN, CT 06511-4411
(203) 785-2140
(203) 785-6414
Mailing address
1423 CHAPEL ST, UNIT B, NEW HAVEN, CT 06511-4411
(203) 785-7998
(203) 785-6414
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036872
CT
Other
Enumeration date
11/22/2005
Last updated
07/08/2007
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