Crystal L Jackson, PA C

NPI #1548298953 in South Orange, New Jersey

Provider Information

NPI Number: 1548298953
Entity Type: Individual
Name: Crystal L Jackson, PA C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA C
Enumeration Date: Jun 28, 2006
Last Updated: Jun 24, 2010

Practice Location

Address: 61 1ST ST
City: South Orange
State: New Jersey
ZIP Code: 07079-1900
Phone: (973) 762-8344

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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