Provider Demographics
NPI:1164675674
Name:RENDALL, JENNIFER (MS,PA-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:RENDALL
Suffix:
Gender:F
Credentials:MS,PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:208 BUNN DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-2851
Mailing Address - Country:US
Mailing Address - Phone:609-683-4999
Mailing Address - Fax:609-683-8222
Practice Address - Street 1:1950 ROUTE 27
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1300
Practice Address - Country:US
Practice Address - Phone:732-297-8866
Practice Address - Fax:732-821-0626
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2016-08-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00208600363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical