Individual
JESSICA PEREIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
999 FRANKLIN AVE, GARDEN CITY, NY 11530-2913
(516) 504-3014
Mailing address
401 THRIFT ST, RONKONKOMA, NY 11779-6234
(631) 471-6063
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
022941
NY
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
09/17/2018
Last updated
12/13/2018
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