National Provider Identifier

Jessica Le Severson, MD

Jessica Le Severson, MD is listed in the NPPES registry with a primary specialty of Dermatology Physician in Batavia, NY and a listed phone number of (585) 344-4811.

NPI 1922171610Batavia, NYDermatology Physician

Profile Overview

NPI
1922171610
Provider Type
Individual
Primary Specialty
Dermatology Physician
Enumeration Date
November 17, 2006
Last Updated
March 17, 2011

Practice Location

  • 229 Summit St
  • Suite 7
  • Batavia, NY 14020-1645

Phone: (585) 344-4811

Mailing Address

  • 601 Elmwood Ave
  • Box 697
  • Rochester, NY 14642-0001

Specialties

  • Dermatology Physician (207N00000X)
  • Dermatology Physician (207N00000X)
Full Record
NPI
1922171610
Entity Type
Individual
Last Name
Severson
First Name
Jessica
Middle Name
Le
Credential
MD
Mailing Street Address
601 Elmwood Ave
Mailing Address Line 2
Box 697
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14642-0001
Mailing Country
US
Mailing Phone
(585) 275-7546
Practice Street Address
229 Summit St
Practice Address Line 2
Suite 7
Practice City
Batavia
Practice State
NY
Practice ZIP Code
14020-1645
Practice Country
US
Practice Phone
(585) 344-4811
Practice Fax
(585) 344-4812
Enumeration Date
November 17, 2006
Last Updated
March 17, 2011
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Dermatology Physician (207N00000X), Dermatology Physician (207N00000X)
Other Identifiers
000919915002 (NY, Community Blue), 00025998201 (NY, Univera), 7851362 (NY, Aetna Insurance), G0183268190 (NY, Blue Choice Group Number), P010224394 (NY, Blue Choice), 2200273 (NY, Ghi), 109598 (NY, Preferred Care), 000919915002 (NY, Blue Cross Of Wny), 0311421 (NY, Independent Health), P010224394 (NY, Rochester Blue Cross)