Provider Demographics
NPI:1245215540
Name:DROWN, JESSICA M (PAC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:M
Last Name:DROWN
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MADISON AVE # 96
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6136
Mailing Address - Country:US
Mailing Address - Phone:973-971-5526
Mailing Address - Fax:973-290-8325
Practice Address - Street 1:100 MADISON AVE # 96
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-971-5526
Practice Address - Fax:973-290-8325
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00154500363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q51425Medicare UPIN
PA094348Medicare ID - Type Unspecified