Provider Demographics
NPI:1427351279
Name:NOVY, JESSICA ANITA (PA-C)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANITA
Last Name:NOVY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ANITA
Other - Last Name:POMPOSELLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:901 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02724-2943
Mailing Address - Country:US
Mailing Address - Phone:508-673-4329
Mailing Address - Fax:
Practice Address - Street 1:901 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02724-2943
Practice Address - Country:US
Practice Address - Phone:508-673-4329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-17
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA4589363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant