Individual provider · Type 1 NPI

Keith Ryan Jackson, MD

Dermatology Physician · Staten Island, NY

NPI number 1124116041 Active

Practice location

11 Ralph Pl, Suite 209
Staten Island, NY 10304-4419

Call (718) 727-1331 Map

Fax (718) 727-2159

Specialties and licenses

TaxonomyCodeLicense
Dermatology Physician Primary 207N00000X212165 (NY)

Dermatology Physician: A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis an…

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About NPI 1124116041

Keith Ryan Jackson, MD's National Provider Identifier is 1124116041, issued on Oct 10, 2006. The primary taxonomy on file is Dermatology Physician (207N00000X), and the practice location is in Staten Island, NY. The record was last updated on May 28, 2013.