| Doctor Name: | JESSICA ANN KOSCELNAK |
| NPI Number: | 1053388801 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 334804 |
| Business Practice Address: | 40 Mitchell Avenue Binghamton, NY - 13903 |
| Business Phone Number: | 6077720639 |
| Business Fax Number: | 6077224610 |
| Mailing Address: | 346 Grand Ave, JOHNSON CITY |
| State: | NY |
| Postal Code: | 137902558 |
| Phone Number: | 6077636293 |
| Fax Number: | 6077636717 |
| NPI Enumeration Date: | 03/01/2006 |
| NPI Last Update Date: | 01/05/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 334804 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |