Search › New York › 363A00000X
Jessica Petchonka, PA-C
NPI 1518360536 · on the registry since 2014
Practice
- Address
- 496 County Road 111
Building B
Manorville, NY 11949 - Phone
- (631) 405-3200
- Fax
- (631) 395-6010
- Organisation at this address
- Cvs Albany Llc
Pure Dental Of Long Island Pc
Peconic Bay Medical Services, P.C.Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 17
Additional practice sites
- 148 Natures Ln, Miller Place, NY
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Licence states on file
- NY
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2020-06-01
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York