Individual
MS. JENNIFER ANN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPAC
Contact information
Practice address
19 LAUREL AVE STE 102, CORNWALL, NY 12518-1403
(845) 822-8100
(845) 822-8110
Mailing address
19 LAUREL AVE STE 102, CORNWALL, NY 12518-1403
(845) 822-8100
(845) 822-8110
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
006236
NY
Other
Enumeration date
08/13/2007
Last updated
04/29/2022
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