Individual
DR. JESSICA I PETILLA-ONORATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
435 SOUTH ST, SUITE 390, MORRISTOWN, NJ 07960-6422
(973) 971-7022
(973) 290-7046
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
(973) 971-4179
(973) 971-7905
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
209121
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
25MA06863700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02648295
—
NY
Enumeration date
08/26/2005
Last updated
02/01/2017
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