Jon-Paul Bourgelais
Physician Assistant in New York, NY. Individual provider (NPI-1).
NPI number1972396331
StatusActive
Last updated in NPPESMay 27, 2025
Details
- NPI
- 1972396331
- Entity type
- Individual (NPI-1)
- Name
- Jon-Paul Bourgelais
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 27, 2025
- Certification date
- May 27, 2025
- Last updated
- May 27, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
Practice location
100 E 77th StNew York, NY 10075-1850
Phone 212-434-2000
Mailing address
100 E 77th StNew York, NY 10075-1850
Phone 212-434-2000
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