Individual
DR. KAEDREA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
451 CLARKSON AVE, BROOKLYN, NY 11203-2054
(718) 245-4795
Mailing address
2800 MARCUS AVE, BOX 1228, NEW HYDE PARK, NY 11042-1113
(718) 245-4790
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
255061
NY
207R00000X
Internal Medicine Physician
255061
NY
Other
Enumeration date
06/15/2007
Last updated
02/16/2016
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