Provider Demographics
NPI:1669898177
Name:VANELLA, ROSE (PA-C)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:VANELLA
Suffix:
Gender:F
Credentials:PA-C
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:BLDG. D, SUITE 220
Mailing Address - City:MERCERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3882
Mailing Address - Country:US
Mailing Address - Phone:609-581-2200
Mailing Address - Fax:609-581-1212
Practice Address - Street 1:1225 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:BLDG. D, SUITE 220
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619-3882
Practice Address - Country:US
Practice Address - Phone:609-581-2200
Practice Address - Fax:609-581-1212
Is Sole Proprietor?:No
Enumeration Date:2014-03-07
Last Update Date:2019-03-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00329200363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical