Jenna Edlin, PA-C
Physician Assistant in Port Jefferson Station, NY. Individual provider (NPI-1).
NPI number1669800751
StatusActive
Last updated in NPPESMar 14, 2025
Details
- NPI
- 1669800751
- Entity type
- Individual (NPI-1)
- Name
- Jenna Edlin
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 29, 2013
- Certification date
- Mar 14, 2025
- Last updated
- Mar 14, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 016790 | NY | Yes |
Practice location
5316 Nesconset HwyPort Jefferson Station, NY 11776-2591
Phone 631-474-0707 · Fax 631-562-2108
Mailing address
1 Research RdRidge, NY 11961-2701
Phone 631-751-3000
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All 36 Physician Assistant providers in Port Jefferson Station · All 1,186 providers in Port Jefferson Station
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