Provider Demographics
NPI:1023821808
Name:JP PA HEALTH PLLC
Entity type:Organization
Organization Name:JP PA HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEZHMANNIA
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:516-234-0839
Mailing Address - Street 1:26 ELM ST
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1202
Mailing Address - Country:US
Mailing Address - Phone:516-418-2328
Mailing Address - Fax:
Practice Address - Street 1:26 ELM ST
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-1202
Practice Address - Country:US
Practice Address - Phone:516-234-0839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center