Individual
JENNIFER CONSALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1306 HIGH ST N, MILLVILLE, NJ 08332-2532
(856) 875-3630
Mailing address
1301 S LINCOLN AVE APT 918, VINELAND, NJ 08361-6692
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00610500
NJ
Other
Enumeration date
06/03/2021
Last updated
06/03/2021
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