Individual
MRS. JESSICA R PETRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
655 MADISON STREET, SYRACUSE, NY 13210
(315) 473-8700
(315) 473-8707
Mailing address
251 SALINA MEADOWS PARKWAY, SUITE 100, SYRACUSE, NY 13212
(315) 464-2000
(315) 464-2010
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
383447
NY
363L00000X
Nurse Practitioner
383447
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
383447
NY
Other
Enumeration date
09/27/2022
Last updated
11/07/2024
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