Provider Demographics
NPI:1043597990
Name:DAY-CHRZASZCZ, JESSICA MATTHEWS (PA-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MATTHEWS
Last Name:DAY-CHRZASZCZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8110 MAPLE LAWN BLVD STE 235
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2694
Mailing Address - Country:US
Mailing Address - Phone:301-340-8339
Mailing Address - Fax:301-340-9027
Practice Address - Street 1:659 S SALISBURY BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5453
Practice Address - Country:US
Practice Address - Phone:410-543-9111
Practice Address - Fax:410-543-9115
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110003657363A00000X
MDC0005340363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC0005340OtherSTATE LICENSE