MEDICARE: JESSICA VITARELLI NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	26NJ15341900	NJ

General Provider Information

NPI Number	:	1700770245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA VITARELLI NP

Provider Business Mailing Address
First Line	:	301 LIPPINCOTT DR STE 410
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-4197
Country	:	US
Telephone Number	:	856-374-4440
Fax Number	:	856-374-4445

Provider Business Practice Location Address
First Line	:	401 KINGS HIGHWAY SOUTH, BUILDING 5
Second Line	:
City	:	CHERRY HILL
State	:	NJ
Zip	:	08034
Country	:	US
Telephone Number	:	856-374-4440
Fax Number	:	856-374-4445

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2025
Last Update Date	:	01/28/2026

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