Individual provider · Type 1 NPI

Jessica Gibson, PA-C

Surgical Physician Assistant · East Patchogue, NY

NPI number 1871186445 Active

Practice location

285 Sills Rd Bldg 18
East Patchogue, NY 11772-4808

Fax (631) 475-1588

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X027549 (NY)
Physician Assistant 363A00000X027549 (NY)

Surgical Physician Assistant: Definition to come...

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About NPI 1871186445

Jessica Gibson, PA-C's National Provider Identifier is 1871186445, issued on Feb 15, 2021. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in East Patchogue, NY. The record was last updated on Nov 16, 2021.