Dr. Kaedrea Jackson, M.D.
Emergency Medicine in Brooklyn, NY. Individual provider (NPI-1).
NPI number1982809497
StatusActive
Last updated in NPPESFeb 16, 2016
Details
- NPI
- 1982809497
- Entity type
- Individual (NPI-1)
- Name
- Dr. Kaedrea Jackson
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 15, 2007
- Last updated
- Feb 16, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | 255061 | NY | Yes |
| 207R00000X | Internal Medicine | 255061 | NY |
Practice location
451 Clarkson AveBrooklyn, NY 11203-2054
Phone 718-245-4795
Mailing address
2800 Marcus AveBox 1228
New Hyde Park, NY 11042-1113
Phone 718-245-4790
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