Keith Ryan Jackson in Staten Island - Dermatology
Keith Ryan Jackson - NPI 1124116041
Keith Ryan Jackson is a Dermatology in Staten Island, New York. Keith Ryan Jackson practices all healthcare services and medical treatments related to Dermatology. The NPI Number for Keith Ryan Jackson is 1124116041. The last update date is 2013-05-28.
Keith Ryan Jackson's current location address is 11 Ralph Pl, Staten Island, New York. You can contact this provider via phone number 7187271331 and fax number 7187272159. The mailing address for Keith Ryan Jackson is 11 Ralph Pl, Staten Island, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Keith Ryan Jackson |
|---|---|
| Address | 11 Ralph Pl, Staten Island, New York |
| Phone Number | 7187271331 |
| Fax Number | 7187272159 |
| Sole Proprietor | Y |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1124116041 |
|---|---|
| Provider Enumeration Date | 2006-10-10 |
| Last Updated Date | 2013-05-28 |
Provider Mailing Address Detail
| Address | 11 Ralph Pl |
|---|---|
| City | Staten Island |
| State | New York (NY) |
| Post Code | 103044419 |
| Phone Number | 7187271331 |
| Fax Number | 7187272159 |
Provider's Primary Taxonomy Detail
| Speciality | Dermatology |
|---|---|
| Taxonomy | 207N00000X |
| Licence No | 212165 |
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Definition: A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2239307 | NY | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Keith Ryan Jackson by the Centers for Medicare & Medicaid Services?
The Keith Ryan Jackson has been issued the NPI (National Provider Identifier) 1124116041 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you provide the complete address where Keith Ryan Jackson is physically located?
The Keith Ryan Jackson is situated at the following address: 11 Ralph Pl, Staten Island, NY 103044419.
What is the area of specialization for Keith Ryan Jackson, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Keith Ryan Jackson is Dermatology, and the corresponding taxonomy code that categorizes this area of expertise is 207N00000X.
On what date was the 1124116041 assigned to Keith Ryan Jackson?
The Keith Ryan Jackson was issued its 1124116041 on 2006-10-10, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Keith Ryan Jackson, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Keith Ryan Jackson, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2013-05-28.
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