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Individual

MR. ERIC ROBERT JACKSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
201 LYONS AVE, NEWARK, NJ 07112-2027
(973) 926-7000
Mailing address
1 VAUTRIN AVE, HOLTSVILLE, NY 11742-1613
(631) 603-6038

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary

Other

Enumeration date
07/03/2025
Last updated
07/03/2025
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