Individual
JACQUELYN BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
150 BERGEN ST, NEWARK, NJ 07103
(973) 972-5672
(973) 972-0365
Mailing address
30 BERGEN ST RM 1205, NEWARK, NJ 07107-3000
(973) 972-0037
(973) 972-0743
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MB10390700
NJ
Other
Enumeration date
05/04/2015
Last updated
02/22/2022
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