Individual
DIANE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2995 CURRY RD, SCHENECTADY, NY 12303-2801
(518) 836-2200
(518) 836-2201
Mailing address
2995 CURRY RD, SCHENECTADY, NY 12303-2801
(518) 836-2200
(518) 836-2201
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
22579157
NY
Other
Enumeration date
01/16/2014
Last updated
01/16/2014
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