Individual provider · Type 1 NPI
Jennifer Alicea Revoredo, PA
Medical Physician Assistant · South Orange, NJ
NPI number
1801239363
Active
Practice location
20 Valley St Ste 320
South Orange, NJ 07079-2881
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 25MP00304400 (NJ) |
Medical Physician Assistant: Definition to come...
5 other providers at this address
- Ashlyne Nicky Mejia, NPFamily Nurse Practitioner South Orange, NJ NPI 1184595290
- Oneka Edwards, APNFamily Nurse Practitioner South Orange, NJ NPI 1023895257
- Priscillia Angie Assale, NPPrimary Care Nurse Practitioner South Orange, NJ NPI 1902689383
- Samantha R. MinottFamily Nurse Practitioner South Orange, NJ NPI 1063980688
- Shyla Imani Kissoon, PA-CPhysician Assistant South Orange, NJ NPI 1790399483
Other medical physician assistant providers in South Orange
About NPI 1801239363
Jennifer Alicea Revoredo, PA's National Provider Identifier is 1801239363, issued on Apr 15, 2013. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in South Orange, NJ. The record was last updated on Mar 7, 2017.