Willert, Jessica Lynn

Willert, Jessica Lynn is an individual health care provider with primary practice located at 255 Lafayette Ave , Suffern NY 10901-4812. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Willert, Jessica Lynn can be contacted via phone (845) 368-5039.

Contact Information

Primary practice address
255 Lafayette Ave Suffern NY 10901-4812
Phone: (845) 368-5039
Fax: (845) 368-5327
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 25MA07996300 New Jersey
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 243789 New York

Profile Details

NPI number 1457324048
LBN Legal business name Willert, Jessica Lynn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Oct 2nd, 2013 - about 11 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 1457324048 NPPES
New York MEDICAID 02868931
New York MEDICAID 0085774
New York Other P00601586

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