Jacknin, Mark Aaron
Jacknin, Mark Aaron is an sole proprietor health care provider with primary practice located at 4405 Broadway , New York NY 10040-4014. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jacknin, Mark Aaron can be contacted via phone (212) 740-2020.Contact Information
Primary practice address
4405 Broadway
New York NY 10040-4014
Phone: (212) 740-2020
Fax: (646) 666-0280
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 230171 | New York |
Profile Details
| NPI number | 1033179338 |
|---|---|
| LBN Legal business name | Jacknin, Mark Aaron |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | Sep 1st, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033179338 | NPPES |
| New York | MEDICAID | 02716663 |
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