Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

MS. Jennifer Alicea Revoredo, PA

Individual provider Medical Physician Assistant · NPI 1801239363

MS. Jennifer Alicea Revoredo, PA is a Medical Physician Assistant in South Orange, New Jersey. Licensed in New Jersey. Registered with an NPI since 2013.

Licensed in
NJ
In the registry since
2013
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

20 Valley St Ste 320
South Orange, NJ 07079-2881
Phone: (973) 313-1113
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 25MP00304400 (NJ)

Record details

NPI number1801239363
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedApril 15, 2013
Last updated in NPPESMarch 7, 2017

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