Individual
JENNIFER KEAT-WYSOCKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
750 BRUNSWICK AVE, CAPITAL HEALTH TRAUMA DEPARTMENT, TRENTON, NJ 08638-4143
(609) 394-6000
Mailing address
PO BOX 8500-1611, PHILADELPHIA, PA 19178-0001
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
25MP00089000
NJ
Other
Enumeration date
04/06/2007
Last updated
10/22/2008
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