Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 40QA00960100 | NJ |
NPI | 1508865379 |
---|---|
Provider Name | Mrs. Jennifer Lynne Perno |
First Address | Sewell, NJ 08080-2661 |
Second Address | Sewell, NJ 08080-2661 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 31/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1555347 | AMERIHEALTH (01) | NJ |
2107652 | FIRST HEALTH (01) | NJ |
51405 | ORTHONET (01) | NJ |