NPI 1003204678

Vanessa Jackson

Practitioner Adult Care Home Facility Far Rockaway, NY

Practice location

Address: 2922 Falcon Ave, Far Rockaway, NY 11691-1845
Phone: (347) 576-9654

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence 320584 (NY)

Other Custodial Care Facility providers in New York →

Registry record

NPI: 1003204678
Entity type: Individual
Sex (as registered): Female
NPI issued: 5 Jan 2015
Record last updated: 5 Jan 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.