East Side Endocrine PLLC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

Legal business name

EAST SIDE ENDOCRINE PLLC

Practice address

103 E 75TH St
New York, NY 10021-2805

Phone

(212) 772-7628

NPI assigned

Mar 15, 2024

Last updated

Mar 15, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Clifton Jackness, MDNPI 1346402716

Title

Owner

Phone

(212) 772-7628

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Clifton Jackness, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • New York, NY
  • NPI 1346402716
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1710460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710460800000",
    "number": "1932968641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 E 75TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212805",
            "telephone_number": "212-772-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 E 75TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212805",
            "telephone_number": "212-772-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SIDE ENDOCRINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-15",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A",
        "authorized_official_last_name": "JACKNESS",
        "authorized_official_first_name": "CLIFTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-772-7628",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Side Acupuncture PC
• East Side Cardiology PLLC
• East Side Chemists Inc
• East Side Dental Arts PLLC (Murphy Dental)
• East Side Dermatology Services PC (Laser & Skin Surgery Center of New York)
• East Side Endoscopy LLC
• East Side Esda Inc D/B/a East Side Dental Arts
• East Side Foot Care PC
• East Side Gastroenterology, P.C.
• East Side Medical & Cardiovascular Associates, P.C.

• Endocrinology, Diabetes & Metabolism Physician in New York, NY
• Providers in New York, NY by specialty
• Endocrinology, Diabetes & Metabolism Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.