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1588407720
JESSICA LORRAINE WALLACE
STATEN ISLAND, NY
NPI
1588407720
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
Enumeration Date
2024-06-17
Last Update Date
2024-06-17
Business Address
Ms. JESSICA LORRAINE WALLACE PA
332 GREAT KILLS RD
STATEN ISLAND, NY 10308-3515
Phone number: 917-525-7209
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Mailing Address
Ms. JESSICA LORRAINE WALLACE PA
332 GREAT KILLS RD
STATEN ISLAND, NY 10308-3515
Phone number: 917-525-7209
Copy
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