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Search › New York › 104100000X

Crystal Jackson

NPI 1588211692 · on the registry since 2019

Practice

Address
456 Waverly Ave
Patchogue, NY 11772
Phone
(631) 447-6460
Organisation at this address
Risewell Community Services
Federation Of Organizations For The Ny State Mentally Disabled Inc
Federation Of Organizations For The New York State Mentally Disabled
Inferred from a shared address, not stated in the registry.
Clinicians at this address
20

Additional practice sites

  • 1 Route 109, West Babylon, NY

Registry record

Primary taxonomy
104100000X
104100000X
Also registered as
104100000X
Licence states on file
NY
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2019-08-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York