Individual
JESSICA MARIE MAGIONCALDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
100 GRANNY RD STE 1, FARMINGVILLE, NY 11738-2879
(631) 696-4957
Mailing address
6 CIRCLE CT, FARMINGVILLE, NY 11738-2309
(631) 459-0344
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
405989
NY
Other
Enumeration date
08/06/2024
Last updated
08/21/2024
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