Individual
JESSICA PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1626 PUTNEY RD, VALLEY STREAM, NY 11580-1818
(347) 512-0204
Mailing address
1626 PUTNEY RD, VALLEY STREAM, NY 11580-1818
(347) 512-0204
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NY
Other
Enumeration date
06/23/2025
Last updated
06/23/2025
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