Individual
DIPAN KAUR JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P
Contact information
Practice address
1978 CROMPOND ROAD, ST 201, CORTLAND MANOR, NY 10567
(646) 539-0945
Mailing address
1978 CROMPOND ROAD, ST 201, CORTLAND MANOR, NY 10567
(646) 539-0945
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
338360
NY
Other
Enumeration date
10/16/2013
Last updated
12/01/2022
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