Individual
JESSICA ESCALANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4046 75TH ST, ELMHURST, NY 11373-1012
(718) 335-7437
Mailing address
4046 75TH ST, ELMHURST, NY 11373-1012
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
015241
NY
Other
Enumeration date
11/01/2011
Last updated
11/01/2011
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