Provider Demographics
NPI:1578958492
Name:VALLOREO, JESSICA (PT, DPT, OCS, SCS)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:VALLOREO
Suffix:
Gender:F
Credentials:PT, DPT, OCS, SCS
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:RUTH
Other - Last Name:JENNINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:175 NJ-70
Mailing Address - Street 2:19
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-1522
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:175 ROUTE 70
Practice Address - Street 2:19
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2300
Practice Address - Country:US
Practice Address - Phone:609-714-3378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01604100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist