Healthcare Provider Details

I. General information

NPI: 1780898585
Provider Name (Legal Business Name): JESSICA ISABELLE DE LAMOTA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 WILLIAMSON ST
ELIZABETH NJ
07202-3625
US

IV. Provider business mailing address

225 WILLIAMSON ST
ELIZABETH NJ
07202-3625
US

V. Phone/Fax

Practice location:
  • Phone: 908-994-5204
  • Fax:
Mailing address:
  • Phone: 908-994-5204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number88702
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number249970-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MB08527900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: