Individual
MR. JASON PAUL PREVELIGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
56 FRANKLIN ST, WATERBURY, CT 06706-1221
(203) 709-6004
(203) 709-3700
Mailing address
56 FRANKLIN ST, WATERBURY, CT 06706-1221
(203) 709-8873
(203) 709-8689
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
002305
CT
Other
Enumeration date
09/10/2009
Last updated
09/22/2022
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