Individual
JEANNE SEVERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
202 W 102ND ST, APT # 3EF, NEW YORK, NY 10025-8700
(917) 399-8736
(212) 316-6130
Mailing address
202 W 102ND ST, APT # 3EF, NEW YORK, NY 10025-8700
(917) 399-8736
(212) 316-6130
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
003776
NY
363AM0700X
Medical Physician Assistant
Primary
003776
NY
Other
Enumeration date
08/19/2014
Last updated
08/19/2014
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