Individual
JESSICA NACKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1200 DRIVING PARK AVE STE 4, NEWARK, NY 14513-1090
(315) 359-2696
(315) 359-2699
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(315) 359-2696
(315) 359-2699
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
020740
NY
Other
Enumeration date
08/15/2014
Last updated
12/16/2022
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