Doctor Name: | JENNIFER ESTELA-STOLLWERCK |
NPI Number: | 1609234160 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 26NJ00609400 |
Business Practice Address: | 744 Galloping Hill Road Roselle Park, NJ - 07204 |
Business Phone Number: | 9082410044 |
Business Fax Number: | |
Mailing Address: | 744 Galloping Hill Road, ROSELLE PARK |
State: | NJ |
Postal Code: | 07204 |
Phone Number: | 9082410044 |
Fax Number: | |
NPI Enumeration Date: | 01/29/2016 |
NPI Last Update Date: | 01/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | 26NJ00609400 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |