Individual
JESSICA JEONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
357 GENESEE ST STE 2, ONEIDA, NY 13421-2658
(315) 363-2123
(315) 363-2549
Mailing address
357 GENESEE ST STE 2, ONEIDA, NY 13421-2658
(315) 363-2123
(315) 363-2549
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
019444
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04383982
—
NY
Enumeration date
08/07/2015
Last updated
05/02/2019
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