JESSICA LORRAINE WALLACE

STATEN ISLAND, NY
NPI1588407720
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
Enumeration Date2024-06-17
Last Update Date2025-01-24
Business Address
Ms. JESSICA LORRAINE WALLACE PA
355 BARD AVE
STATEN ISLAND, NY 10310-1664
Phone number: 718-818-1234
Mailing Address
Ms. JESSICA LORRAINE WALLACE PA
332 GREAT KILLS RD
STATEN ISLAND, NY 10308-3515
Phone number: 917-525-7209
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