Individual
MS. NERISSA NICOLE KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
36 NEWARK AVE, BELLEVILLE, NJ 07109-4119
(973) 429-2209
(973) 429-2210
Mailing address
1 HARMON PLZ FL 3, SECAUCUS, NJ 07094-2803
(551) 257-7039
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00398500
NJ
Other
Enumeration date
06/14/2016
Last updated
02/07/2024
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