Gabrielle Jackson
Physician Assistant in New York, NY. Individual provider (NPI-1).
NPI number1407581374
StatusActive
Last updated in NPPESJul 23, 2022
Details
- NPI
- 1407581374
- Entity type
- Individual (NPI-1)
- Name
- Gabrielle Jackson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 23, 2022
- Certification date
- Jul 23, 2022
- Last updated
- Jul 23, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
Practice location
575 Lexington AveNew York, NY 10022-6102
Phone 646-962-7277
Mailing address
575 Lexington AveNew York, NY 10022-6102
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