Jessica Lillian Wollenberg
Oral and Maxillofacial Pathology
447 Route 10 Suite 5
Randolph
, New Jersey 07869-2132
Jessica Lillian Wollenberg
Oral and Maxillofacial Pathology
447 Route 10 Suite 5
Randolph
, New Jersey 07869-2132
(973) 328-3405
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Jessica Lillian Wollenberg
- 447 Route 10 Suite 5
- Randolph, NJ
- Zip : 07869-2132
- Fax : (973) 328-3405
- Phone : (973) 328-0464
Second Address
- Jessica Lillian Wollenberg
- 447 Route 10 Suite 5
- Randolph, NJ
- Zip : 07869-2132
- Fax : (973) 328-3405
- Phone : (973) 328-0464
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 22DI02546000 | NJ |
National Provider Identifier
| NPI | 1770801888 |
|---|---|
| Provider Name | Jessica Lillian Wollenberg |
| First Address | Randolph, NJ 07869-2132 |
| Second Address | Randolph, NJ 07869-2132 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/05/2010 |
| Last Update Date | 08/10/2013 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.