Provider Demographics
NPI:1467765677
Name:CASSIDY, JENNA M (RPA-C)
Entity Type:Individual
Prefix:MS
First Name:JENNA
Middle Name:M
Last Name:CASSIDY
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Gender:F
Credentials:RPA-C
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Mailing Address - Street 1:124 ROSA RD
Mailing Address - Street 2:SUITE 382
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-2143
Mailing Address - Country:US
Mailing Address - Phone:518-386-3691
Mailing Address - Fax:518-386-3553
Practice Address - Street 1:124 ROSA RD
Practice Address - Street 2:SUITE 382
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2143
Practice Address - Country:US
Practice Address - Phone:518-386-3691
Practice Address - Fax:518-386-3553
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2013-04-16
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Provider Licenses
StateLicense IDTaxonomies
NY014079363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical