Michael Addison Jr.
Physician Assistant in Jamaica, NY. Individual provider (NPI-1).
NPI number1386018331
StatusActive
Last updated in NPPESNov 13, 2015
Details
- NPI
- 1386018331
- Entity type
- Individual (NPI-1)
- Name
- Michael Addison Jr.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 13, 2015
- Last updated
- Nov 13, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 019321 | NY | Yes |
Practice location
8268 164th StJamaica, NY 11432-1121
Phone 718-883-3070
Mailing address
8268 164th St1b-02
Jamaica, NY 11432-1121
Phone 718-883-3070
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