Healthcare Provider Details

I. General information

NPI: 1831116656
Provider Name (Legal Business Name): PAULA GRASSO ZOLLNER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 02/21/2025
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 WITHERSPOON ST STE 200
PRINCETON NJ
08540-3224
US

IV. Provider business mailing address

401 ROUTE 73 N BLDG 10, SUITE 320
MARLTON NJ
08053
US

V. Phone/Fax

Practice location:
  • Phone: 609-924-4892
  • Fax: 877-409-2156
Mailing address:
  • Phone: 609-924-4892
  • Fax: 877-409-2156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMA 56554
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA05655400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: