Individual
MICHELLE ANTONUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1 CLARA MAASS DR, BELLEVILLE, NJ 07109
(973) 450-2000
Mailing address
425 MEMORIAL PKWY, BLOOMFIELD, NJ 07003-4266
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00437300
NJ
Other
Enumeration date
06/21/2017
Last updated
07/26/2018
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