Individual
CHAD JAGGON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
852 W GATE, VALLEY STREAM, NY 11580-1553
(917) 804-5126
Mailing address
852 W GATE, VALLEY STREAM, NY 11580-1553
(917) 804-5126
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
109068
NY
Other
Enumeration date
02/12/2020
Last updated
02/12/2020
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