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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JERREYLL TRAVIS JACKSON, MD

Active Sole Proprietor

JERREYLL TRAVIS JACKSON, MD is a Ophthalmology healthcare provider located in LONG ISLAND CITY, New York. NPI 1629009576 is currently active in the NPPES registry. Verify at CMS.

Ophthalmology · LONG ISLAND CITY, NY

Registration Details

NPI Number
1629009576
Provider Type
Individual
Gender
Male
NPI Issued
Jul 6, 2006 (19.964706633862 yrs)
Last Updated
Dec 8, 2008
Licenses
25MA07982400 (NJ)
043661 (CT)
237264 (NY)
Sole Proprietor
Yes

Practice Information

Address
4604 31ST AVE
LONG ISLAND CITY, NY, 111031842
Browse NY providers · Browse ZIP 11103
Phone
2128891171
Primary Specialty
Ophthalmology
207W00000X
Additional Specialty
Ophthalmology
Additional Specialty
Ophthalmology

Other Ophthalmology Providers in LONG ISLAND CITY, NY

Name Credential NPI
DR. GARY STUART HIRSHFIELD M.D. 1063415420
DR. THEODORE LYU M.D. 1760704803
MATTHEW FEINSOD MD 1972800829
DR. SUMAYYA AHMAD M.D. 1760777064
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.