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Contact Information

TERESA A JACKSON, MSED
41 GREEN ST
VALLEY STREAM, NY11580-4815
 Phone: 516-285-6388
 Fax: 516-285-6388
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Contractor

171W00000X
Indicates primary specialty

NPI Profile & details for TERESA A JACKSON · (Female)

NPI # 1972865442
Status Active
Credentials MSED
Entity Individual
Enumeration date 06/11/2012
Last updated 06/11/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 486110931
  • NY License # 486112931
  • NY License # 717251962
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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