Provider Demographics
NPI:1992881965
Name:ZAMBELLI, JESSICA L (PA-C)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:ZAMBELLI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 GOODMAN ST N
Mailing Address - Street 2:APT 409
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-1151
Mailing Address - Country:US
Mailing Address - Phone:585-325-2390
Mailing Address - Fax:585-325-3069
Practice Address - Street 1:277 GOODMAN ST N
Practice Address - Street 2:APT 409
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-1151
Practice Address - Country:US
Practice Address - Phone:412-519-5027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011756-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant