Individual
MRS. JENNELLE PINEDA-LALOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00464500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101491103
US POSTAL/DEPT OF LABOR
NJ
01
—
1356434286
NPI
NJ
01
—
4620425
AETNA PROVIDER #
NJ
01
—
6268160
CIGNA
NJ
01
—
P3654688
OXFORD
NJ
Enumeration date
10/02/2006
Last updated
07/18/2018
Update your record
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