# J & G MEDICAL ASSOCIATES PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184042079
- **Authorized official:** MR. JAISON CHAKKAPPAN ARNP (PRESIDENT)
- **Authorized official phone:** (914) 602-6209

## Contact information

- **Practice address:** 8958 W STATE ROAD 84 STE 342, DAVIE, FL 33324-4457
- **Practice address phone:** (914) 602-6209
- **Practice address fax:** (954) 357-1175
- **Mailing address:** 8958 W STATE ROAD 84 STE 342, DAVIE, FL 33324-4457
- **Mailing address phone:** (914) 602-6209
- **Mailing address fax:** (954) 357-1175

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/29/2014
- **Last updated:** 08/17/2021