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General NPI Number Information
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NPI Number | 1598423667
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Entity Type | Individual
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Provider Name | JACQUELINE SERRITELLA PMHNP-BC, APN
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Gender | Female
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Dates
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Enumeration Date | 12/06/2021
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Last Update Date | 01/01/2026
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Provider Practice Location Address
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Address Line | 151 YARMOUTH CT
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City | HOLMDEL
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State | NJ
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Zip | 07733-1079
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Country | US
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Telephone | 201-247-4868
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Fax |
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Provider Business Mailing Address
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Address Line | 151 YARMOUTH CT
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City | HOLMDEL
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State | NJ
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Zip | 07733-1079
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Country | US
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Telephone | 732-241-7218
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Fax | 732-858-0172
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 745959
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 26NJ15446500
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR12449800
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License Number State | NJ
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