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Individual

JESSICA RESO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
85 SEYMOUR ST STE 919, HARTFORD, CT 06106-5528
(860) 696-5520
(860) 522-3951
Mailing address
85 SEYMOUR ST STE 919, HARTFORD, CT 06106-5528
(860) 696-5520
(860) 522-3951

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
020023
NY
363AS0400X
Surgical Physician Assistant
Primary
5170
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020023
NYS LICENSE
NY
Enumeration date
08/17/2016
Last updated
09/15/2021
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