Individual
JILLIAN D'AMICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3333 HYLAN BLVD, STATEN ISLAND, NY 10306-3608
(718) 448-3210
Mailing address
111 GALWAY PL, TEANECK, NJ 07666-3640
(201) 833-9500
(201) 862-0095
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
017455
NY
363AS0400X
Surgical Physician Assistant
25MP00318500
NJ
Other
Enumeration date
12/18/2013
Last updated
03/06/2020
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