Jessica Petchonka, PA-C

NPI #1518360536 in Manorville, New York

Provider Information

NPI Number: 1518360536
Entity Type: Individual
Name: Jessica Petchonka, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Oct 4, 2014
Last Updated: Jun 1, 2020

Practice Location

Address: 496 COUNTY ROAD 111
Address 2: BUILDING B
City: Manorville
State: New York
ZIP Code: 11949-3383
Phone: (631) 405-3200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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