Jessica Marie Donofrio, PA-C
Physician Assistant, Medical in Islandia, NY. Individual provider (NPI-1).
NPI number1326443029
StatusActive
Last updated in NPPESNov 15, 2021
Details
- NPI
- 1326443029
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Jessica Marie Donofrio
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 24, 2014
- Certification date
- Nov 15, 2021
- Last updated
- Nov 15, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 018211 | NY | Yes |
Practice location
1050 Old Nichols RdIslandia, NY 11749-5026
Phone 631-828-4545
Mailing address
32 Patricia LnLake Grove, NY 11755-2843
Phone 631-375-0138
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