Provider Demographics
NPI:1093899486
Name:MEGER, JESSICA L (MS, ATC, PA-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:MEGER
Suffix:
Gender:F
Credentials:MS, ATC, PA-C
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Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:585-723-7281
Mailing Address - Fax:585-723-7280
Practice Address - Street 1:1625 STRAITS TPKE
Practice Address - Street 2:SUITE #211
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-1836
Practice Address - Country:US
Practice Address - Phone:203-573-9512
Practice Address - Fax:203-568-2904
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2021-05-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY0012812255A2300X
CT002603363A00000X
NY026563363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant