Keith Ryan Jackson Md Pc in Staten Island - Dermatology
Keith Ryan Jackson Md Pc - NPI 1326216847
Keith Ryan Jackson Md Pc is a Dermatology in Staten Island, New York. Keith Ryan Jackson Md Pc practices all healthcare services and medical treatments related to Dermatology. The NPI Number for Keith Ryan Jackson Md Pc is 1326216847. The last update date is 2013-05-29.
Keith Ryan Jackson Md Pc'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 Md Pc is 11 Ralph Pl, Staten Island, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Keith Ryan Jackson Md Pc |
|---|---|
| Address | 11 Ralph Pl, Staten Island, New York |
| Phone Number | 7187271331 |
| Fax Number | 7187272159 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Jackson Ryan Keith |
| Credentials | M.D. |
| Telephone Number | 7187271331 |
NPI Number Detail
| NPI Number | 1326216847 |
|---|---|
| Provider Enumeration Date | 2008-02-19 |
| Last Updated Date | 2013-05-29 |
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 |
|
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 Keith Ryan Jackson Md Pc's 1326216847?
The Keith Ryan Jackson Md Pc's NPI (National Provider Identifier) Number is 1326216847. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Keith Ryan Jackson Md Pc is physically located?
The Keith Ryan Jackson Md Pc is situated at the following address: 11 Ralph Pl, Staten Island, NY 103044419.
What is the Keith Ryan Jackson Md Pc's specialty and taxonomy code?
The Keith Ryan Jackson Md Pc's specialty is Dermatology, and the corresponding taxonomy code is 207N00000X.
On what date did the Keith Ryan Jackson Md Pc receive its 1326216847 assignment from the Centers for Medicare & Medicaid Services?
The Keith Ryan Jackson Md Pc was assigned its 1326216847 by the Centers for Medicare & Medicaid Services on 2008-02-19.
As of what date was the information pertaining to Keith Ryan Jackson Md Pc, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Keith Ryan Jackson Md Pc, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2013-05-29.
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