DR. ERIC ALLEN JACKSON (NPI# 1366470262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366470262 |
| Entity Type | Individual |
| Full Name | DR. ERIC ALLEN JACKSON |
| Credential | PHARM.D. |
| Practice Address |
99 Woodland St Hartford CT 06105-1207 |
| Mailing Address |
137 Main St Collinsville CT 06019-3135 |
| Practice Telephone | 8607146533 |
| Practice Fax Number | 8607148079 |
| Mailing Telephone | 8606934671 |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
4920 | CT | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447728910 | Eric Jackson | Specialist/Technologist | 1219 6th Ave S, Birmingham, AL 35233 | 2018-11-02 |
| 1043725211 | Eric Jackson | Counselor | 51 Lima St, Aurora, CO 80010-4616 | 2017-12-09 |
| 1164733267 | Eric Jackson | Speech-Language Pathologist | 75 Pierrepont St Apt 3d, Brooklyn, NY 11201-2429 | 2010-06-23 |
| 1083764559 | Eric Jackson | Dentist | 9631b Fm 1960 Rd W, Houston, TX 77070-6110 | 2007-01-10 |
| 1518042233 | Eric A Jackson | Emergency Medicine | 811 Sixth Street, Suite #210, Wichita Falls, TX 76301 | 2006-10-25 |
| 1164510202 | Eric Winfred Jackson | Physical Therapist | 3662 Inwood Avenue, New Orleans, LA 70131 | 2006-10-11 |
| 1235131251 | Eric M Jackson | Internal Medicine | 16-18 Ridge Road, North Rlington, NJ 07031-6314 | 2005-08-10 |
| 1205298734 | Eric Jackson | Pediatrics | 240 E Huron St, Mcgaw Pavilion Suite 1-200, Chicago, IL 60611-2909 | 2016-03-23 |
| 1205200011 | Eric Jackson | Counselor | 770 Woodlane Rd, Westampton, NJ 08060-3804 | 2015-11-17 |
| 1235531823 | Eric T Jackson | Social Worker | 110 Hidden Valley Rd, Mc Murray, PA 15317-2685 | 2014-09-25 |
| Street Address |
99 WOODLAND ST |
| City | HARTFORD |
| State | CT |
| Zip Code | 06105-1207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952396020 | Fonda Gravino | Family Medicine | 99 Woodland St, Hartford, CT 06105-1207 | 2005-09-15 |
| 1093337909 | Laura Chaplin | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2020-05-13 |
| 1952930349 | Jared Michael Kozal | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2020-04-07 |
| 1568091007 | Nirali Patel | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2020-04-06 |
| 1922637917 | Yukari Ueda | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2020-04-02 |
| 1720540099 | Andria Danielle Matthews | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2019-04-04 |
| 1154883064 | Kiran A Lorick | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2019-04-01 |
| 1144782053 | Elizabeth Anne Darsan | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2019-04-01 |
| 1942760947 | Alex Mafdali | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2019-03-25 |
| 1700383015 | Kristen Alison Island | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2018-04-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275155939 | Pruthwy R Addanki | Student in an Organized Health Care Education/Training Program | Saint Francis Clinic, 1000 Asylum Avenue, Suite 1004, Hartford, CT 06105 | 2020-05-15 |
| 1700447802 | Samuel Flynn | Student in an Organized Health Care Education/Training Program | 1000 Asylum Avenue, Suite 3200, Hartford, CT 06105 | 2019-06-28 |
| 1730743568 | Turab J Mohammed | Student in an Organized Health Care Education/Training Program | Saint Francis Hospital Clinic, 1000 Asylum Avenue, Suite 1004, Hartford, CT 06105 | 2019-04-26 |
| 1164900387 | Breanne Ferrara | Social Worker | 43 Wooland St, Hartford, CT 06105 | 2018-07-31 |
| 1154814069 | Signature Smiles of Hartford LLC | Dentist | 550 Farmington Avenue, Suite B, Hartford, CT 06105 | 2018-06-14 |
| 1356839062 | Jaimy Villavicencio | Student in an Organized Health Care Education/Training Program | 100 Asylum Avenue, Suite 1004, Hartford, CT 06105 | 2018-04-27 |
| 1750885679 | Brittany Bird | Student in an Organized Health Care Education/Training Program | 839-841 Asylum Avenue, Hartford, CT 06105 | 2018-03-23 |
| 1972032241 | Ashley Nicole Mills | Student in an Organized Health Care Education/Training Program | 896 Asylum Ave, 3rd Floor, Hartford, CT 06105 | 2017-06-08 |
| 1528506847 | Samuel Agyei | Social Worker | 291 Collins St, Hartford, CT 06105 | 2017-02-07 |
| 1841735818 | Katie Strahowski | Nurse Practitioner | 85 Gillett Street, Clean Slate, Hartford, CT 06105 | 2016-12-30 |
| Find all providers in zip 06105 | ||||
| Taxonomy Code | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457588220 | Maria A Summa | Pharmacist | 114 Woodland Street Department of Pharmacy, Saint Francis Hospital and Medical Center, Hartford, CT 06105 | 2009-06-18 |
| 1518021138 | Craig Ian Coleman | Pharmacist | 80 Seymour St # Cb309, Hartford Hospital, Hartford, CT 06102-8000 | 2006-12-20 |
| 1053474619 | Fei Wang | Pharmacist | 79 Retreat Ave, Adult Primary Care Practice, Hartford, CT 06106-2527 | 2006-12-18 |
| 1285791301 | William Leslie Baker Jr. | Pharmacist | 80 Seymour St, Cb309, Hartford, CT 06102-8000 | 2007-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619524584 | Anshu Chen | Pharmacist | 290 Box Mountain Dr, Vernon, CT 06066-6309 | 2019-08-24 |
| 1841654225 | Ramalakshmi Devadi | Pharmacist | 1035 Washington Blvd, Stamford, CT 06901-2204 | 2016-04-11 |
| 1013293851 | Alec Theis | Pharmacist | 3265 Berlin Tpke, T1802, Newington, CT 06111-5101 | 2011-10-25 |
| 1609990159 | Lorna Zammett | Pharmacist | 112 Medford St, Bristol, CT 06010-3683 | 2007-03-19 |
| 1528192812 | David Nederhood | Pharmacist | 55 Northwood Dr, Guilford, CT 06437-1127 | 2007-03-16 |
| 1285727354 | Richard Lawrence Kubarek | Pharmacist | 114 Beebe Hill Rd, Falls Village, CT 06031-1612 | 2006-10-02 |
| 1700996733 | Jaime L Correia | Pharmacist | 555 Willard Ave # 119, Newington, CT 06111-2631 | 2006-08-31 |
| 1104809185 | Nancy Chapman Kastner | Pharmacist | 1 Wahoo Ave Bldg 449, Naval Ambulatory Care Center Attn: Prof. Affairs, Groton, CT 06340-2324 | 2005-11-23 |
| 1043207160 | Michelle Angela Page | Pharmacist | 366 W Mountain Rd, West Simsbury, CT 06092-2913 | 2005-10-04 |
| 1669464459 | Patrick Joseph Tannone | Pharmacist | 14 Ridge Rd, New Milford, CT 06776-3131 | 2005-08-17 |
| 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.