National Provider Identifier
Jacksons Health Family Health NP
Jacksons Health Family Health NP is listed in the NPPES registry with a primary specialty of Primary Care Clinic/Center in Rochester, NY and a listed phone number of (585) 340-6940.
Profile Overview
- NPI
- 1194494880
- Provider Type
- Organization
- Primary Specialty
- Primary Care Clinic/Center
- Enumeration Date
- September 07, 2021
- Last Updated
- September 08, 2024
Practice Location
- 1655 Elmwood Ave Ste 125
- Rochester, NY 14620-3428
Phone: (585) 340-6940
Mailing Address
- 978 Clinton Ave S
- Rochester, NY 14620-2040
Specialties
- Primary Care Clinic/Center (261QP2300X)
Full Record
- NPI
- 1194494880
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Jacksons Health Family Health NP
- Mailing Street Address
- 978 Clinton Ave S
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14620-2040
- Mailing Country
- US
- Mailing Phone
- (585) 576-1001
- Practice Street Address
- 1655 Elmwood Ave Ste 125
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14620-3428
- Practice Country
- US
- Practice Phone
- (585) 340-6940
- Enumeration Date
- September 07, 2021
- Last Updated
- September 08, 2024
- Authorized Official Last Name
- Jackson
- Authorized Official First Name
- Carnel
- Authorized Official Title
- Owner
- Authorized Official Phone
- (585) 340-6940
- Organization Subpart
- No
- Authorized Official Credential Text
- FNP
- Certification Date
- September 08, 2024
- Taxonomies
- Primary Care Clinic/Center (261QP2300X)