Provider Demographics
NPI:1437296886
Name:KATTAN, JESSICA (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:KATTAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42-09 28TH STREET
Mailing Address - Street 2:CN#46, 9TH FLOOR, CUBICLE 9-138
Mailing Address - City:QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4132
Mailing Address - Country:US
Mailing Address - Phone:347-396-4280
Mailing Address - Fax:347-396-4323
Practice Address - Street 1:42-09 28TH STREET
Practice Address - Street 2:CN#46, 9TH FLOOR, CUBICLE 9-138
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11101-4132
Practice Address - Country:US
Practice Address - Phone:347-396-4280
Practice Address - Fax:347-396-4323
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY263178-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine