Individual
JESSICA ACQUAVIVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 WHITE RD, SUITE 115, LITTLE SILVER, NJ 07739-1150
(732) 747-1925
Mailing address
1500 SAINT GEORGES AVE, AVENEL, NJ 07001-1000
(732) 574-0742
(732) 574-0142
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00411100
NJ
363A00000X
Physician Assistant
—
—
Other
Enumeration date
09/08/2016
Last updated
04/06/2022
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