Most Relevant Information
Provider Data
| NPI Number: | 1003679762 |
| Provider Name: | RACHEL ALEXA JACKSON RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WS0200X |
| Specialty: | Registered Nurse |
| License Number: | 773251 |
Most Important Dates
| Enumeration Date: | 02/05/2024 |
| Last Updated: | 02/05/2024 |
Provider Practice Location
100 MYRTLE AVE
MAHOPAC
NY
105414641
Practice Location Phone/Fax
| Phone: | 8456216600 |
| Fax: | 8456280644 |
Provider Mailing Location
149 JACKSON RD
HOPEWELL JCT
NY
125338608
Provider Mailing Phone/Fax
| Phone: | 8457053563 |
| Fax: |