| NPI | 1033179338 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2006-03-23 |
| Last Updated | 2023-09-01 |
| Mailing Address | Po Box 746087 Atlanta, GA 30374-6087 United States Phone: (312) 733-9730 📍 View Map |
| Primary Practice Address | 4405 Broadway New York, NY 10040-4014 United States Phone: (212) 740-2020 | Fax: (646) 666-0280 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | NY | 02716663 | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 207Q00000X – Family Medicine | NY | 230171 |
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About NPI 1033179338
Mark Aaron Jacknin D.O. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1033179338. The primary specialty listed is Family Medicine. The provider is located in New York, NY. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-03-23. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1033179338?
NPI 1033179338 belongs to Mark Aaron Jacknin D.O., a Family Medicine in New York, NY. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1033179338 active?
The current status of NPI 1033179338 in the NPPES registry is Active. The record was last updated on 2023-09-01.
What specialty is NPI 1033179338?
NPI 1033179338 is classified under the taxonomy Family Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1033179338?
You can verify NPI 1033179338 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1033179338?
The primary practice address on file for NPI 1033179338 is 4405 Broadway, New York, NY 10040-4014. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1033179338 issued?
NPI 1033179338 was first issued (enumerated) on 2006-03-23. The NPPES record was last updated on 2023-09-01.
Practice Location Map
Mark Aaron Jacknin is located at 4405 Broadway, New York, NY. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Mark Aaron Jacknin. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1033179338. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Family Medicine | 230171 | NY |