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General NPI Number Information
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NPI Number | 1376555789
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Entity Type | Individual
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Provider Name | ERICK F JACKOWSKY P.T., D.P.T
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Gender | Male
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 03/26/2013
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Provider Practice Location Address
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Address Line | 715 NEWARK POMPTON TPKE
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-1330
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Country | US
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Telephone | 973-835-6115
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Fax | 973-835-6861
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Provider Business Mailing Address
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Address Line | 715 NEWARK POMPTON TPKE
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-1330
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Country | US
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Telephone | 973-835-6115
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Fax | 973-835-6861
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA00234100
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License Number State | NJ
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