Jackus, Kimberly A
Jackus, Kimberly A is an individual health care provider with primary practice located at 3127 41St St , Astoria NY 11103-3901. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Jackus, Kimberly A can be contacted via phone (718) 721-6989.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 186183-1 | New York |
Profile Details
| NPI number | 1558367540 |
|---|---|
| LBN Legal business name | Jackus, Kimberly A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 23rd, 2005 |
| Last updated | Sep 5th, 2013 - about 11 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 | 1558367540 | NPPES |
| New York | MEDICAID | 02111686 |
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