Individual
JACOB EMANUEL BEVILACQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, CRNA
Contact information
Practice address
1 COOPER PLZ, CAMDEN, NJ 08103-1461
(856) 342-2000
Mailing address
3 COOPER PLZ, CAMDEN, NJ 08103-1438
(856) 356-4935
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
26NR15502700
NJ
367500000X
Certified Registered Nurse Anesthetist
RN2297562
MA
Other
Enumeration date
03/29/2013
Last updated
04/16/2015
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