Paonessa, Jessica E
Paonessa, Jessica E is an individual health care provider with primary practice located at 1221 Sixth St Ste 100 , Traverse City MI 49684. She recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as her primary health care specialty. Paonessa, Jessica E can be contacted via phone (231) 935-0322.Contact Information
Primary practice address
1221 Sixth St Ste 100
Traverse City MI 49684
Phone: (231) 935-0322
Fax: (231) 935-0334
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 274692 | New York |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 01071233A | Indiana |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 4301113807 | Michigan |
Profile Details
| NPI number | 1386760122 |
|---|---|
| LBN Legal business name | Paonessa, Jessica E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 22nd, 2007 |
| Last updated | Sep 13th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386760122 | NPPES |
| New York | MEDICAID | 03884526 | |
| New York | MEDICAID | 201112070 | |
| New York | Other | 000000792827 |
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