Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Keith Ryan Jackson MD PC

Organization Dermatology Physician · NPI 1326216847

Keith Ryan Jackson MD PC is a Dermatology Physician in Staten Island, New York. Licensed in New York. Registered with an NPI since 2008.

Licensed in
NY
In the registry since
2008
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

11 Ralph Pl Ste 209
Staten Island, NY 10304-4419
Phone: (718) 727-1331
Fax: (718) 727-2159
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 212165 (NY)

Record details

NPI number1326216847
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Keith Jackson — President · (718) 727-1331
NPI enumeratedFebruary 19, 2008
Last updated in NPPESMay 29, 2013
Mailing address11 Ralph Pl, Suite 209, Staten Island, NY 10304-4419

Other providers in Staten Island