Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jerreyll Travis Jackson, MD

Individual provider Ophthalmology Physician · NPI 1629009576

Jerreyll Travis Jackson, MD is an Ophthalmology Physician in Long Island City, New York. Practices as a sole proprietor. Licensed in Connecticut, New Jersey and New York.

Licensed in
CT, NJ, NY
In the registry since
2006
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4604 31st Ave
Long Island City, NY 11103-1842
Phone: (212) 889-1171
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ophthalmology Physician (primary) Taxonomy 207W00000X · Licence 237264 (NY)
Ophthalmology Physician Taxonomy 207W00000X · Licence 25MA07982400 (NJ)
Ophthalmology Physician Taxonomy 207W00000X · Licence 043661 (CT)

Record details

NPI number1629009576
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 6, 2006
Last updated in NPPESDecember 8, 2008

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