Jackson, Lisa Nicole

Jackson, Lisa Nicole is an individual health care provider with primary practice located at 89-06 135Th St Room 6A, Jamaica NY 11418. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Jackson, Lisa Nicole can be contacted via phone (718) 206-6808.

Contact Information

Primary practice address
89-06 135Th St Room 6A Jamaica NY 11418
Phone: (718) 206-6808
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 60 245188 New York

Profile Details

NPI number 1487844973
LBN Legal business name Jackson, Lisa Nicole
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2007
Last updated Jul 31st, 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.

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