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1003645144
JASON KETTENRING
NEW YORK, NY
NPI
1003645144
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2024-07-29
Last Update Date
2024-07-29
Business Address
JASON KETTENRING
177 FT WASHINGTN AVE
NEW YORK, NY 10032-3733
Phone number: 212-305-2500
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Mailing Address
JASON KETTENRING
14517 17TH RD
WHITESTONE, NY 11357-3026
Phone number: 347-756-2728
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