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

Richard Jensen

Individual provider Physician Assistant · NPI 1417963588

Richard Jensen is a Physician Assistant in Peru, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2006

Practice location Address checks out

3384 State Route 22
Peru, NY 12972-5305
Phone: (518) 643-8008
Fax: (518) 643-8090
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5546 (NY)

Record details

NPI number1417963588
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 31, 2006
Last updated in NPPESJuly 8, 2007
Mailing address553 Stevenson Rd, Westport, NY 12993-2219

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