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General NPI Number Information
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NPI Number | 1023821808
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Entity Type | Organization
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Legal Business Name | JP PA HEALTH PLLC
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 26 ELM ST
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City | ROSLYN HEIGHTS
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State | NY
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Zip | 11577-1202
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Country | US
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Telephone | 516-234-0839
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Fax |
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Provider Business Mailing Address
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Address Line | 26 ELM ST
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City | ROSLYN HEIGHTS
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State | NY
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Zip | 11577-1202
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Country | US
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Telephone | 516-418-2328
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | JONATHAN PEZHMANNIA
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Credential | PA-C
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Telephone | 516-234-0839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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