Provider Demographics
NPI:1497949796
Name:PU, JESSICA L (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:PU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:154 COBBLESTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-7965
Mailing Address - Country:US
Mailing Address - Phone:412-580-7519
Mailing Address - Fax:732-228-8416
Practice Address - Street 1:1802 OAK TREE RD STE 101
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2704
Practice Address - Country:US
Practice Address - Phone:732-548-3210
Practice Address - Fax:732-228-8416
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2018-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08718500208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics