JESSICA LORRAINE WALLACE

STATEN ISLAND, NY
NPI1588407720
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: NY  032571)
Additional Taxonomies363AM0700X Physician Assistant, Medical
Enumeration Date2024-06-17
Last Update Date2025-08-14
Business Address
Ms. JESSICA LORRAINE WALLACE PA
355 BARD AVE
STATEN ISLAND, NY 10310-1664
Phone number: 718-818-2995
Mailing Address
Ms. JESSICA LORRAINE WALLACE PA
355 BARD AVE
STATEN ISLAND, NY 10310-1664
Phone number: 718-818-2995