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NPI Code Detail

MEDICARE: DR. JOSEPH JACKSON DPT, OCS

MEDICARE: DR. JOSEPH JACKSON DPT, OCS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist41653CA
22251X0800XOrthopedic Physical Therapist041736NY

General Provider Information

NPI Number : 1467854265
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH JACKSON DPT, OCS
Provider Business Mailing Address
First Line : 41 CLARK ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-2415
Country : US
Telephone Number : 646-518-5566
Fax Number :
Provider Business Practice Location Address
First Line : 41 CLARK ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-2415
Country : US
Telephone Number : 646-518-5566
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2014
Last Update Date : 07/21/2022

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Directions to “ DR. JOSEPH JACKSON DPT, OCS” Practice Location

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