Most Relevant Information
Provider Data
| NPI Number: | 1003215237 |
| Provider Name: | JACQUELINE J JERVIS PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | 3136 |
Most Important Dates
| Enumeration Date: | 08/13/2014 |
| Last Updated: | 06/26/2019 |
Provider Practice Location
281 SEASIDE AVE
MILFORD
CT
064604601
Practice Location Phone/Fax
| Phone: | 2038789718 |
| Fax: |
Provider Mailing Location
281 SEASIDE AVE
MILFORD
CT
064604601
Provider Mailing Phone/Fax
| Phone: | 2038789718 |
| Fax: |