Jennifer Goonetilleke
Physician Assistant in Caldwell, NJ(View on Map)
Full Name
Jennifer Goonetilleke
NPI Number
1437535226
NPI Type
Individual Provider
Gender
Female
Enumeration Date
08/04/2015
Specialties
(Taxonomies)Licenses
State
New Jersey
New York
License Number
25MP00408700
9004287
Contact
Information
Purpose
Mailing
Location
Address
51 ROSELAND AVE APT 18
51 ROSELAND AVE APT 18
City
Caldwell
Caldwell
State
NJ
NJ
Postal Code
07006-5923
07006-5923
Country
US
US
Telephone Number
N/A
(551) 486-6363
Identifiers
Identifier
0674184
Identifier State
NJ
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 09/26/2024
Provider Address
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