Individual
DR. JASON RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
150 55TH ST, BROOKLYN, NY 11220-2508
(718) 630-7452
Mailing address
150 55TH ST # LB3101, BROOKLYN, NY 11220-2508
(718) 630-7452
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
310591
NY
Other
Enumeration date
04/02/2017
Last updated
08/23/2022
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