Individual
JACINDA PIETANZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
38 KENNEDY BLVD, OLD BRIDGE, NJ 08857-3935
(732) 251-0154
Mailing address
38 KENNEDY BLVD, OLD BRIDGE, NJ 08857-3935
(732) 251-0154
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006449-1
NY
Other
Enumeration date
08/17/2008
Last updated
08/17/2008
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