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1801239363
JENNIFER ALICEA REVOREDO
SOUTH ORANGE, NJ
NPI
1801239363
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: NJ 25MP00304400)
Enumeration Date
2013-04-15
Last Update Date
2017-03-07
Business Address
Ms. JENNIFER ALICEA REVOREDO PA
20 VALLEY ST STE 320
SOUTH ORANGE, NJ 07079-2881
Phone number: 973-313-1113
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Mailing Address
Ms. JENNIFER ALICEA REVOREDO PA
20 VALLEY ST STE 320
SOUTH ORANGE, NJ 07079-2881
Phone number: 973-313-1113
Copy
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