Individual
MR. ANTHONY CURTIS JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA
Contact information
Practice address
1901 1ST AVE, NEW YORK, NY 10029-7404
(212) 423-6262
Mailing address
539 RALPH AVE # 4, BROOKLYN, NY 11233-4903
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
018007
NY
Other
Enumeration date
10/01/2014
Last updated
10/01/2014
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