Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
COLLEEN A JACKSON
ActiveNutrition, Education · PATCHOGUE, NY
Registration Details
- NPI Number
- 1669629275
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 26, 2008 (17.693235438215 yrs)
- Last Updated
- Aug 26, 2008
- License
-
004661 (NY)
Practice Information
- Address
-
101 HOSPITAL RDPATCHOGUE, NY, 117724870Browse NY providers · Browse ZIP 11772
- Phone
- 6316547236
- Primary Specialty
-
Nutrition, Education
133NN1002X
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.