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General NPI Number Information
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NPI Number | 1891780789
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Entity Type | Individual
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Provider Name | JENNY S PATERYN P.A.-C
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Gender | Female
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Dates
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Enumeration Date | 09/16/2005
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Last Update Date | 07/10/2017
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Provider Practice Location Address
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Address Line | 1500 EAST MEDICAL CENTER DRIVE 2ND FLOOR TAUBMAN CENTER RECP F
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City | ANN ARBOR
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State | MI
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Zip | 48109-5332
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Country | US
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Telephone | 734-936-5738
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Fax | 734-936-6927
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Provider Business Mailing Address
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Address Line | 29355 NORTHWESTERN HWY # 302
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1053
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Country | US
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Telephone | 734-936-2047
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 5601001549
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License Number State | MI
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