Jamie Petrancosta
Physician Assistant in New York, NY. Individual provider (NPI-1).
NPI number1982153151
StatusActive
Last updated in NPPESApr 6, 2022
Details
- NPI
- 1982153151
- Entity type
- Individual (NPI-1)
- Name
- Jamie Petrancosta
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 28, 2016
- Certification date
- Apr 6, 2022
- Last updated
- Apr 6, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 020158 | NY | Yes |
Practice location
1275 York AveNew York, NY 10065-6007
Phone 212-639-2000
Mailing address
1275 York AveNew York, NY 10065-6007
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