Provider Demographics
NPI:1184042079
Name:J & G MEDICAL ASSOCIATES PA
Entity Type:Organization
Organization Name:J & G MEDICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAISON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAKKAPPAN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:914-602-6209
Mailing Address - Street 1:8958 W STATE ROAD 84 STE 342
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-4457
Mailing Address - Country:US
Mailing Address - Phone:914-602-6209
Mailing Address - Fax:954-357-1175
Practice Address - Street 1:8958 W STATE ROAD 84 STE 342
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33324-4457
Practice Address - Country:US
Practice Address - Phone:914-602-6209
Practice Address - Fax:954-357-1175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-29
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty