Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nazreenbanu Jolly, PA-C

Individual provider Physician Assistant · NPI 1326803909

Nazreenbanu Jolly, PA-C is a Physician Assistant in Ithaca, New York. Qualified in 2023, 3 years ago. Practices with Skin Dermatology, LLC, a 5-clinician group and accepts Medicare assignment.

Years since qualifying
3
In the registry since
2024
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

953 Danby Rd
Ithaca, NY 14850-7000
Phone: (607) 274-3011
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1326803909
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 14, 2024
Last updated in NPPESFebruary 14, 2024
Certification dateFebruary 14, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Skin Dermatology, Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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