Individual
JESSICA DECOURCEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3 CURTIS RD, VERNON, NY 13476-3607
(315) 829-2220
(315) 829-3955
Mailing address
3 CURTIS RD, VERNON, NY 13476-3607
(315) 829-2220
(315) 829-3955
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
024100
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5921779
—
NY
Enumeration date
05/01/2019
Last updated
10/11/2023
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