Individual
JESSICA S KOVALCHICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
105 RIDGEHAVEN DR, VESTAL, NY 13850-2640
(607) 798-6176
Mailing address
105 RIDGEHAVEN DR, VESTAL, NY 13850-2640
(607) 798-6176
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
017256
NY
363AM0700X
Medical Physician Assistant
MA054574
PA
Other
Enumeration date
09/19/2010
Last updated
03/01/2023
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