Topaz, Jackson

Topaz, Jackson is an sole proprietor health care provider with primary practice located at 3600 Route 112 , Coram NY 11727-4116. He recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as his primary health care specialty. Topaz, Jackson can be contacted via phone (631) 920-8500.

Contact Information

Primary practice address
3600 Route 112 Coram NY 11727-4116
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X

Profile Details

NPI number 1245993450
LBN Legal business name Topaz, Jackson
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 15th, 2021
Last updated Oct 15th, 2021 - 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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