Individual
MRS. JESSICA NICOLE O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
3670 SOUTH BENZING RD, SUITE C, ORCHARD PARK, NY 14127
(716) 675-5711
(716) 675-1358
Mailing address
3670 SOUTH BENZING RD, SUITE C, ORCHARD PARK, NY 14127
(716) 675-5711
(716) 675-1358
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
005077
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000570066007
BCBS
NY
01
—
0021056603
UNIVERA
NY
05
—
02345619
—
NY
01
—
9511995
INDEPENDENT HEALTH
NY
Enumeration date
03/08/2007
Last updated
10/14/2019
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