Individual
DR. JACQUELINE ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
802 W PARK AVE, SUITE 213, OCEAN, NJ 07712-8527
(732) 695-2555
(732) 695-2552
Mailing address
PO BOX 603725, CHARLOTTE, NC 28260-3725
(828) 575-2625
(828) 350-2174
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
25MA09114400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0297909
—
NJ
01
—
242744ZKRP
MEDICARE PTAN
NJ
01
—
242744ZVF5
MEDICARE PTAN
NJ
Enumeration date
06/02/2010
Last updated
10/30/2023
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