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NPI Code Detail

MEDICARE: JESSICA MARIA BONET

MEDICARE:   JESSICA MARIA BONET
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant027330NY
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1275152118
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MARIA BONET
Provider Business Mailing Address
First Line : 250 E 39TH ST APT 11M
Second Line :
City : NEW YORK
State : NY
Zip : 10016-2178
Country : US
Telephone Number : 484-213-1206
Fax Number :
Provider Business Practice Location Address
First Line : 570 LEXINGTON AVE FL 9
Second Line :
City : NEW YORK
State : NY
Zip : 10022-6710
Country : US
Telephone Number : 646-962-7277
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2020
Last Update Date : 09/29/2022

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Directions to “ JESSICA MARIA BONET ” Practice Location

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