Female

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)

Code

363A00000X

Primary Taxonomy

Yes

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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