Jackson, Leland Jay

Jackson, Leland Jay is an individual health care provider with primary practice located at 5006 W Genesee St , Camillus NY 13031-2326. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jackson, Leland Jay can be contacted via phone (315) 234-2342.

Contact Information

Primary practice address
5006 W Genesee St Camillus NY 13031-2326
Phone: (315) 234-2342
Fax: (315) 234-0697
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 171536 New York

Profile Details

NPI number 1386616472
LBN Legal business name Jackson, Leland Jay
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 3rd, 2006
Last updated Mar 7th, 2023 - about last year

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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Identifiers

StateTypeNumberIssuer
All States NPI 1386616472 NPPES
New York MEDICAID 01348347
New York Other 171536

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