# JACQUELINE SMITH, MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790116374
- **Authorized official:** DR. CYNTHIA ACEVEDO (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (973) 928-3341

## Contact information

- **Practice address:** 716 BROAD ST, SUITE 2A, CLIFTON, NJ 07013-1645
- **Practice address phone:** (973) 221-3122
- **Practice address fax:** (973) 710-0620
- **Mailing address:** 716 BROAD STREET, SUITE 2A, CLIFTON, NJ 07013-1607
- **Mailing address phone:** (973) 221-3122
- **Mailing address fax:** (973) 710-0620

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 25MA09182300 | NJ | Yes |

## Other

- **Enumeration date:** 12/06/2013
- **Last updated:** 12/06/2013