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

DESIREE JACKSON

Active Sole Proprietor

DESIREE JACKSON is a Early Intervention Provider Agency healthcare provider located in NORTH BALDWIN, New York. NPI 1699150268 is currently active in the NPPES registry. Verify at CMS.

Early Intervention Provider Agency · NORTH BALDWIN, NY

Registration Details

NPI Number
1699150268
Provider Type
Individual
Gender
Female
NPI Issued
Jul 24, 2015 (11.10538947242 yrs)
Last Updated
Jul 24, 2015
License
1773076 (NY)
Sole Proprietor
Yes

Practice Information

Address
2127 MARION PL
NORTH BALDWIN, NY, 115102921
Browse NY providers · Browse ZIP 11510
Phone
6467390985
Primary Specialty
Early Intervention Provider Agency
252Y00000X

Other Early Intervention Provider Agency Providers in NORTH BALDWIN, NY

Name Credential NPI
CAREN MICHELLE COLONNA 1154759439
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.