Jennifer Petrelli

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-16-22463 Issued in NJ

Practice address

101 E Gate Dr
Cherry Hill, NJ 08034-2803

Phone

(856) 810-7599

NPI assigned

Jul 11, 2016

Last updated

Jul 11, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Lynn Hettenbach Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1508218835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 EDWARDS AVE",
            "city": "BARRINGTON",
            "state": "NJ",
            "postal_code": "080071233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E GATE DR",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342803",
            "telephone_number": "856-810-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRELLI",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NJ",
            "license": "1-16-22463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HETTENBACH",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aaron Pete, OTR/L
• Brooke Petersen, LCSW
• Ebony S Peterson-Jay
• Andrew M Peterson, PHARMD
• Jillian Kyle Petracco, OTR
• Giustine Petrilli, MA, BCBA
• Thais K Petrocelli, OTRL
• Jillian Petty, OT
• Deborah Ann Pezzella, NP-C
• Mackenzie Pezzi, OT

• Behavior Analyst in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Behavior Analyst in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.