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

Organization subpart

No

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

Authorized official

Name

Clifton Jackness, MD

Title

Owner

Phone

(212) 772-7628

Specialties & licenses 1

Addresses

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": []
}

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• 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.