Revoredo, Jennifer Alicea

Revoredo, Jennifer Alicea is an individual health care provider with primary practice located at 20 Valley St Ste 320 , South Orange NJ 07079-2881. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Revoredo, Jennifer Alicea can be contacted via phone (973) 313-1113.

Contact Information

Primary practice address
20 Valley St Ste 320 South Orange NJ 07079-2881
Phone: (973) 313-1113
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 25MP00304400 New Jersey

Profile Details

NPI number 1801239363
LBN Legal business name Revoredo, Jennifer Alicea
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 15th, 2013
Last updated Mar 7th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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