Doctor Name: | SHEENA LENE JACKSON |
NPI Number: | 1003105396 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSED |
License Number: | |
Business Practice Address: | 1965 Schieffelin Ave #1c Bronx, NY - 104665614 |
Business Phone Number: | 7185159273 |
Business Fax Number: | 7185159273 |
Mailing Address: | 1965 Schieffelin Ave, #1c BRONX |
State: | NY |
Postal Code: | 104665614 |
Phone Number: | 7185159273 |
Fax Number: | 7185159273 |
NPI Enumeration Date: | 04/07/2011 |
NPI Last Update Date: | 04/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |