Individual
JENNIFER ELIZABETH VILCACHAGUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
230 BROAD ST, BLOOMFIELD, NJ 07003-7607
(201) 983-4062
Mailing address
230 BROAD ST, BLOOMFIELD, NJ 07003-7607
(201) 983-4062
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00794200
NJ
Other
Enumeration date
08/04/2023
Last updated
09/16/2025
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