Individual
JESSICA VICTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
620 W 42ND ST APT 10C, NEW YORK, NY 10036-2022
(516) 606-3391
Mailing address
620 W 42ND ST APT 10C, NEW YORK, NY 10036-2022
(516) 606-3391
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XV49992P
METROPLUS
NY
Enumeration date
09/16/2022
Last updated
09/16/2022
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