Individual
JESSICA LYNNE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2350 RIDGEWAY AVE, SUITE A, ROCHESTER, NY 14626-4127
(585) 922-2440
(585) 663-3293
Mailing address
2350 RIDGEWAY AVE, SUITE A, ROCHESTER, NY 14626-4127
(585) 922-2440
(585) 663-3293
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
010137
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010137
—
NY
01
—
PA0512
PREFERRED CARE
NY
01
—
PO19010137
BLUE CHOICE
NY
Enumeration date
07/18/2006
Last updated
05/15/2012
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