DR. LYNETTE MICHELLE JACKSON (NPI# 1902247521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902247521 |
| Entity Type | Individual |
| Full Name | DR. LYNETTE MICHELLE JACKSON |
| Credential | PHARM.D. |
| Practice Address |
224 Hamburg Tpke Sjwh Pharmacy Department Wayne NJ 07470-2111 |
| Mailing Address |
325 Palisade Ave Apt 3f Jersey City NJ 07307-1714 |
| Practice Telephone | 9739563395 |
| Practice Fax Number | 9733894015 |
| Mailing Telephone | 8625712261 |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2013-07-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
28RI03309200 | NJ | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902116486 | Lynette Jackson | Social Worker | 1530 W River Rd N Ste 300, Elyria, OH 44035 | 2010-10-18 |
| Street Address |
224 HAMBURG TPKE SJWH PHARMACY DEPARTMENT |
| City | WAYNE |
| State | NJ |
| Zip Code | 07470-2111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598760829 | St. Joseph's Wayne Hospital | General Acute Care Hospital | 224 Hamburg Tpke, Wayne, NJ 07470-2111 | 2005-06-14 |
| 1649836867 | Ian Rabinowitz | Nurse Practitioner | 224 Hamburg Tpke, Wayne, NJ 07470-2168 | 2019-05-13 |
| 1821568817 | Marianne Elizabeth Cavanaugh | Nurse Practitioner | 224 Hamburg Tpke, Wayne, NJ 07470-2168 | 2018-12-03 |
| 1811427198 | Sameh Scander | Internal Medicine | 224 Hamburg Tpke, Wayne, NJ 07470-2168 | 2017-06-19 |
| 1851741284 | Murtuza Tameem | Hospitalist | 224 Hamburg Tpke, Wayne, NJ 07470-2168 | 2016-06-16 |
| 1871957951 | Md Assist LLC | Registered Nurse | 224 Hamburg Tpke, Wayne, NJ 07470-2149 | 2016-04-05 |
| 1235538950 | Mini Willphine | Nurse Practitioner | 224 Hamburg Tpke, Wayne, NJ 07470-2168 | 2014-08-19 |
| 1689082166 | Advanced Practice Group LLC | Nurse Practitioner | 224 Hamburg Tpke, Wayne, NJ 07470-2111 | 2014-07-28 |
| 1043620040 | Abir Rahman | Physical Medicine & Rehabilitation | 224 Hamburg Tpke, Wayne, NJ 07470 | 2014-04-30 |
| 1659705721 | Ursula Zienkiewicz | Pharmacist | 224 Hamburg Tpke, Wayne, NJ 07470-2149 | 2013-08-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073086 | Brightview Hamburg, LLC | Alzheimer Center (Dementia Center) | 1139 Hamburg Turnpike, Wayne, NJ 07470 | 2020-11-03 |
| 1912536301 | Stevenson Dominique | Physician Assistant | 1700 Nj-23 # 170, Wayne, NJ 07470 | 2020-04-07 |
| 1710524087 | Engel Burman At Wayne, LLC | Assisted Living Facility | 1440 Hamburg Turnpike, Wayne, NJ 07470 | 2019-12-05 |
| 1508412669 | Jessie Diana Dunitz | Technician | 66 Sandra Lane, Wayne, NJ 07470 | 2019-08-14 |
| 1447737234 | Meza Behavioral Health, Inc. | Psychologist | 40 Edgemont Crescent, Wayne, NJ 07470 | 2018-07-24 |
| 1881188076 | Christine Nolan | Occupational Therapist | 1 Pike Drive, Wayne, NJ 07470 | 2018-06-20 |
| 1033612403 | County of Passaic Department of Finance | Skilled Nursing Facility | 305 Oldham Road, Wayne, NJ 07470 | 2018-03-13 |
| 1144739590 | Broadway Respite and Home Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7 Allen Drive, Wayne, NJ 07470 | 2017-09-28 |
| 1679096697 | Wafaa Saad | Counselor | 1009 Valley Rd, Wayne, NJ 07470 | 2017-07-21 |
| 1659803138 | Allison Nicole Diangelo | Nurse Practitioner | 1578 Rte 23, Wayne, NJ 07470 | 2017-04-03 |
| Find all providers in zip 07470 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346639259 | Mustafa Faraj | Pharmacist | 80 Carol Pl, Wayne, NJ 07470-2926 | 2015-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255958856 | Pavan K Parimi | Pharmacist | 40 Spruce Meadows Dr, Monroe Township, NJ 08831-3103 | 2020-06-30 |
| 1841814837 | Jibi Philip | Pharmacist | 186 Larch Ave, Dumont, NJ 07628-1327 | 2020-06-04 |
| 1154804185 | Christopher Manuel Bregna | Pharmacist | 60 Fairview Dr, East Hanover, NJ 07936-3508 | 2018-09-14 |
| 1104308121 | Mahwish Zafar | Pharmacist | 1726 Route 37 E, Toms River, NJ 08753-8237 | 2018-09-06 |
| 1386126118 | Panagiota Kousoulis | Pharmacist | 41 Spring St, New Providence, NJ 07974-1143 | 2018-08-29 |
| 1619470606 | Dina Minisi | Pharmacist | 57 Harrowgate Dr, Cherry Hill, NJ 08003-1938 | 2018-03-15 |
| 1720509888 | Sandra Sparta | Pharmacist | 66 Claire Dr, Bridgewater, NJ 08807-1854 | 2017-06-29 |
| 1205377272 | Glatz Rx Consultants LLC | Pharmacist | 54 Broken Arrow Road, Medford, NJ 08055 | 2017-03-10 |
| 1255871745 | Charles W Glatz | Pharmacist | 54 Broken Arrow Bend, Medford, NJ 08055 | 2017-03-02 |
| 1669917613 | Legendary Care Consulting | Pharmacist | 19 Amelia St, North Caldwell, NJ 07006-4155 | 2016-12-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.