Basic Information
Provider Information
NPI: 1750662243
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOLLINGER
FirstName: JESSICA
MiddleName: LEIGH
NamePrefix:  
NameSuffix:  
Credential: RPA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 525 E 68TH ST
Address2: INPATIENT ONCOLOGY PA SERVICE- BOX #325
City: NEW YORK
State: NY
PostalCode: 100654870
CountryCode: US
TelephoneNumber: 2127467576
FaxNumber: 6469620115
Practice Location
Address1: 525 E 68TH ST
Address2: INPATIENT ONCOLOGY PA SERVICE- BOX #325
City: NEW YORK
State: NY
PostalCode: 100654870
CountryCode: US
TelephoneNumber: 2127467576
FaxNumber: 6469620115
Other Information
ProviderEnumerationDate: 08/29/2011
LastUpdateDate: 09/14/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X015007-1NYY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


Home