Individual
JESSICA E RIZKALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
(845) 703-6999
(845) 703-6297
Mailing address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
(845) 703-6999
(845) 703-6297
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
014423
NY
363AM0700X
Medical Physician Assistant
Primary
014423
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03360107
—
NY
Enumeration date
06/17/2011
Last updated
10/14/2020
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