Individual
JESSICA ROSE WISNIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1555 LONG POND ROAD, DEPT OF SURGERY, ROCHESTER, NY 14626-4122
(585) 723-7281
(585) 723-8660
Mailing address
1555 LONG POND ROAD, DEPT OF SURGERY, ROCHESTER, NY 14626-4122
(585) 723-7281
(585) 723-8660
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
022240
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05629025
—
NY
Enumeration date
07/23/2018
Last updated
08/13/2019
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