Jackson, Starr Shalae

Jackson, Starr Shalae is an sole proprietor health care provider with primary practice located at 2627 Hylan Blvd , Staten Island NY 10306-4344. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / General Practice, Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Jackson, Starr Shalae can be contacted via phone (646) 533-0990.

Contact Information

Primary practice address
2627 Hylan Blvd Staten Island NY 10306-4344
Phone: (646) 533-0990
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / General Practice 163WG0000X 345211 New York
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 345211 New York
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 345211 New York

Profile Details

NPI number 1578197588
LBN Legal business name Jackson, Starr Shalae
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 28th, 2020
Last updated Feb 28th, 2020 - about 4 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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