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Individual
MS. JULIANNE RENEE VASCONCELLOS
Active
Individual
MS. JULIANNE RENEE VASCONCELLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
020944-1
NY
363A00000X
Physician Assistant
25MP00439500
NJ
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020944-1
—
NY
01
—
25MP00439500
NEW JERSEY PHYSICIAN ASSISTANT LICENSE
NJ
Enumeration date
06/23/2017
Last updated
09/21/2023
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