National Provider Identifier

Korry Jackson

Korry Jackson is listed in the NPPES registry with a primary specialty of Case Manager/Care Coordinator in Rochester, NY and a listed phone number of (585) 546-3046.

NPI 1083254700Rochester, NYCase Manager/Care Coordinator

Profile Overview

NPI
1083254700
Provider Type
Individual
Primary Specialty
Case Manager/Care Coordinator
Enumeration Date
January 10, 2020
Last Updated
January 10, 2020

Practice Location

  • 1645 Saint Paul St
  • Rochester, NY 14621-3162

Phone: (585) 546-3046

Specialties

  • Case Manager/Care Coordinator (171M00000X)
Full Record
NPI
1083254700
Entity Type
Individual
Last Name
Jackson
First Name
Korry
Mailing Street Address
1645 Saint Paul St
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14621-3162
Mailing Country
US
Mailing Phone
(585) 546-3046
Practice Street Address
1645 Saint Paul St
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14621-3162
Practice Country
US
Practice Phone
(585) 546-3046
Enumeration Date
January 10, 2020
Last Updated
January 10, 2020
Sex
Male
Sole Proprietor
No
Certification Date
January 10, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Case Manager/Care Coordinator (171M00000X)