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NPI Code Detail

MEDICARE: JESSICA GENERAL

MEDICARE: JESSICA GENERAL
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
1163W00000XRegistered Nurse688271-01NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1161039939OTHERNY161039939
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598610974
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA GENERAL
Provider Business Mailing Address
First Line : 4612 MILLENNIUM DR
Second Line :
City : GENESEO
State : NY
Zip : 14454-1197
Country : US
Telephone Number : 585-443-2018
Fax Number :
Provider Business Practice Location Address
First Line : 4612 MILLENNIUM DR
Second Line :
City : GENESEO
State : NY
Zip : 14454-1197
Country : US
Telephone Number : 585-443-2018
Fax Number : 585-991-5013
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2026
Last Update Date : 03/02/2026

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Directions to “ JESSICA GENERAL ” Practice Location

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