Individual
JESSICA DANIELLE FRASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
39 BRENTWOOD RD STE 101, BAY SHORE, NY 11706-8031
(631) 589-7400
Mailing address
985 MANOR LN, BAY SHORE, NY 11706-7516
(631) 943-7516
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
07/29/2013
Last updated
10/16/2019
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