Tontalayah Zuri Jackson

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

344925-01 Issued in NY

Practice address

936 Hoe Ave Apt 2a
Bronx, NY 10459-3653

Phone

(917) 792-7116

NPI assigned

Dec 1, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Tontalayah Green Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1245940121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 HOE AVE APT 2A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104593653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 HOE AVE APT 2A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104593653",
            "telephone_number": "917-792-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TONTALAYAH",
        "middle_name": "ZURI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "344925-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TONTALAYAH",
            "last_name": "GREEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sonji Jackson, CASAC
• Sylvio Jackson
• Tamara Desiree Jackson
• Tawana T Jackson, PT, DPT
• Tiffany Jackson, LMSW
• Tranice D Jackson, M.D.
• Jacob Jaffe,Ed.D. Psychologist PC
• Dianna Elizabeth Jacob, RPA-C
• Jemi Jacob
• Jesslene Jacob

• Licensed Practical Nurse in Bronx, NY
• Providers in Bronx, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.