Individual
DR. JEFFREY KLINE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4337 BROADWAY, NEW YORK, NY 10033-2411
(212) 568-6300
(212) 544-5094
Mailing address
55 WATER ST FL 2, NEW YORK, NY 10041-0010
(646) 680-2888
(516) 542-5556
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036100744
IL
207Q00000X
Family Medicine Physician
Primary
332008
NY
207Q00000X
Family Medicine Physician
MD456697
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
833120
MEDICARE GROUP #
IL
Enumeration date
06/06/2006
Last updated
04/17/2025
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