Individual
DR. KELVIN KARIBO JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
407 ROCKAWAY AVE FL 3, BROOKLYN, NY 11212-5635
(718) 644-0961
Mailing address
3225 FENTON AVE, BRONX, NY 10469-2801
(718) 644-0961
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
272090
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316289853
NPI
NY
Enumeration date
03/29/2006
Last updated
09/30/2019
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