NPI 1023718731

John H Jackson

Practitioner Driver Newark, NJ

Practice location

Address: 66 Hawkins St, Newark, NJ 07105-4318
Phone: (862) 272-9354

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence J0062-40768-06852 (NJ)

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Registry record

NPI: 1023718731
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Mar 2023
Record last updated: 9 Mar 2023

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.