Individual
MR. FAISON JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 BROOKDALE PLZ, BROOKLYN, NY 11212-3139
(718) 240-5000
Mailing address
1 BROOKDALE PLZ, BROOKLYN, NY 11212-3139
(718) 240-5000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
031845
NY
Other
Enumeration date
05/09/2023
Last updated
10/03/2024
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