Provider Demographics
NPI:1578893095
Name:NERONA, JENNIFER CAPIRAL (PT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CAPIRAL
Last Name:NERONA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:476 BAILEY AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-8824
Mailing Address - Country:US
Mailing Address - Phone:646-578-7774
Mailing Address - Fax:
Practice Address - Street 1:1508 E SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-1782
Practice Address - Country:US
Practice Address - Phone:908-486-8899
Practice Address - Fax:908-486-8951
Is Sole Proprietor?:No
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01341600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist