Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 26NJ00575600 | NJ |
NPI | 1013391291 |
---|---|
Provider Name | Mrs. Jennifer Sanfilippo |
First Address | Sea Girt, NJ 08750-1010 |
Second Address | Sea Girt, NJ 08750-1010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2015 |
Last Update Date | 16/07/2015 |