Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. KEITH RYAN JACKSON, M.D.
Active Sole ProprietorDR. KEITH RYAN JACKSON, M.D. is a Dermatology healthcare provider located in STATEN ISLAND, New York. NPI 1124116041 is currently active in the NPPES registry. Verify at CMS.
Dermatology · STATEN ISLAND, NY
Registration Details
- NPI Number
- 1124116041
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 10, 2006 (19.855485316552 yrs)
- Last Updated
- May 28, 2013
- License
-
212165 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
11 RALPH PLSUITE 209STATEN ISLAND, NY, 103044419Browse NY providers · Browse ZIP 10304
- Phone
- 7187271331
- Fax
- 7187272159
- Primary Specialty
-
Dermatology
207N00000X
Other Dermatology Providers in STATEN ISLAND, NY
| Name | Credential | NPI |
|---|---|---|
| DR. CHARLES G BERNSTEIN | MD | 1508847104 |
| MICHAEL KURZMAN | M.D. | 1295707131 |
| DR. DANIEL BUCHEN | MD | 1922069467 |
| DR. JOSIANE LEDERMAN | M.D. | 1619981511 |
| MRS. PATRICIA C MCCORMACK | M.D. | 1891887543 |
| ELLEN BLANK | MD | 1033282900 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.