NPI 1124663505 · live from the CMS NPI Registry
Jessica Kristi Angelone
Physician Assistant, Medical in Medford, NJ. National Provider Identifier 1124663505, active.
NPI record
| NPI | 1124663505 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Medical 363AM0700X |
| Practice location | 103 Old Marlton Pike, Medford, NJ 08055 |
| Practice phone | 609-714-0202 |
| Mailing address | 113 Catherine Ln, Manahawkin, NJ 08050 |
| Enumerated | November 9, 2019 |
| Last updated | March 2, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Medical primary | 363AM0700X | 024336 (NY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.