Provider Demographics
NPI:1235876970
Name:DIBARTOLOMEO, JENNIFER JULIA (PSYD, MED)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JULIA
Last Name:DIBARTOLOMEO
Suffix:
Gender:F
Credentials:PSYD, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1006
Mailing Address - Country:US
Mailing Address - Phone:856-524-0242
Mailing Address - Fax:
Practice Address - Street 1:2002 SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1006
Practice Address - Country:US
Practice Address - Phone:856-524-0242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-15
Last Update Date:2022-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS019570103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical