Provider Demographics
NPI:1942558010
Name:LANCEN-WAHBY, JESSICA N (DO)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:N
Last Name:LANCEN-WAHBY
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Gender:F
Credentials:DO
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Mailing Address - Street 1:222 STATION PLZ N
Mailing Address - Street 2:SUITE 611
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3800
Mailing Address - Country:US
Mailing Address - Phone:516-663-4938
Mailing Address - Fax:516-663-2233
Practice Address - Street 1:175 FULTON AVE
Practice Address - Street 2:#100
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3718
Practice Address - Country:US
Practice Address - Phone:516-292-1034
Practice Address - Fax:516-292-0565
Is Sole Proprietor?:No
Enumeration Date:2012-08-21
Last Update Date:2022-08-22
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Provider Licenses
StateLicense IDTaxonomies
NY278847208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics