Jackson, David Ira

Jackson, David Ira is an individual health care provider with primary practice located at 101 Hospital Road Medical Center, Patchogue NY 11772. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Jackson, David Ira can be contacted via phone (631) 687-2953.

Contact Information

Primary practice address
101 Hospital Road Medical Center Patchogue NY 11772
Phone: (631) 687-2953
Fax: (610) 617-6280
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 005486 New York

Profile Details

NPI number 1013950302
LBN Legal business name Jackson, David Ira
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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