Individual
MRS. CHANDIA ELLEN JACKSON-HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
410 LAKEVILLE RD, SUITE 206A, NEW HYDE PARK, NY 11042-1101
(718) 470-7644
Mailing address
410 LAKEVILLE RD, SUITE 206A, NEW HYDE PARK, NY 11042-1101
(718) 470-7644
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
011057
NY
Other
Enumeration date
02/28/2008
Last updated
02/28/2008
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