Individual
DR. MICHAEL E. JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 GREENE AVE 2D/2E, BROOKLYN, NY 11238-6406
(718) 623-2783
(718) 623-2787
Mailing address
55 GREENE AVE, SUITES 2D/2E, BROOKLYN, NY 11238
(718) 623-2783
(718) 623-2787
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
177618-1
NY
Other
Enumeration date
09/02/2005
Last updated
09/04/2015
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