Jacon, Mary Grace

Jacon, Mary Grace is an individual health care provider with primary practice located at 2 Empire Dr Suite 100, Rensselaer NY 12144-5730. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Jacon, Mary Grace can be contacted via phone (518) 286-4899.

Contact Information

Primary practice address
2 Empire Dr Suite 100 Rensselaer NY 12144-5730
Phone: (518) 286-4899
Fax: (518) 286-4859
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 330909 New York

Profile Details

NPI number 1699736520
LBN Legal business name Jacon, Mary Grace
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2006
Last updated Aug 22nd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699736520 NPPES
New York MEDICAID 02251747

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