Individual
JESSICA BOLZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1184 5TH AVE, NEW YORK, NY 10029-6503
(631) 338-7432
Mailing address
200 E 33RD ST APT 18D, NEW YORK, NY 10016-4829
(631) 338-7432
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
383299
NY
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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