NPI 1619497658 · live from the CMS NPI Registry
Michelle Antonucci, PA
Physician Assistant in Belleville, NJ. National Provider Identifier 1619497658, active.
NPI record
| NPI | 1619497658 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 1 Clara Maass Dr, Belleville, NJ 07109 |
| Practice phone | 973-450-2000 |
| Mailing address | 425 Memorial Pkwy, Bloomfield, NJ 07003 |
| Enumerated | June 21, 2017 |
| Last updated | July 26, 2018 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | 25MP00437300 (NJ) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.