Jackson, Helen T
Jackson, Helen T is an sole proprietor health care provider with primary practice located at 1180 Beacon St Suite 5D, Brookline MA 02446-3885. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Jackson, Helen T can be contacted via phone (617) 277-7583.Contact Information
Primary practice address
1180 Beacon St Suite 5D
Brookline MA 02446-3885
Phone: (617) 277-7583
Fax: (617) 277-5598
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 36280 | Massachusetts |
Profile Details
| NPI number | 1104931062 |
|---|---|
| LBN Legal business name | Jackson, Helen T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104931062 | NPPES |
| Maine | Other | 36280 | LICENSE # |
| Maine | MEDICAID | 2061376 | LICENSE # |
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