Individual
JACK E. REDDING II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
11835 RT 9W, WEST COXSACKIE, NY 12192-3605
(518) 731-9000
(518) 731-9119
Mailing address
60 MARTINS HILL RD, RAVENA, NY 12143-2809
(518) 694-2965
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9100926
FL
Other
Enumeration date
08/25/2006
Last updated
03/27/2015
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