Individual
JEFFREY PAUL TAKACH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2 CENTER PLZ, TINTON FALLS, NJ 07724-9744
(732) 460-5360
(732) 460-7442
Mailing address
411 S RIVERSIDE DR, NEPTUNE, NJ 07753-5840
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00026700
NJ
Other
Enumeration date
05/10/2006
Last updated
07/08/2007
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