Individual
JENNIFER PASQUAICCHIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 VALLEY ST, SOUTH ORANGE, NJ 07079-2887
(813) 971-9351
Mailing address
81 CENTRAL AVE, MONTCLAIR, NJ 07042-3014
(973) 746-3069
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QA01150400
LICENSE#
NJ
Enumeration date
08/29/2006
Last updated
07/08/2007
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