Individual
JACQUES CAROL RAYMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
294 CENTRAL AVE, FL 1, ORANGE, NJ 07050-3414
(973) 676-6556
(973) 676-6543
Mailing address
294 CENTRAL AVE, FL 1, ORANGE, NJ 07050-3414
(973) 676-6556
(973) 676-6543
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MAO7123300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00624016
MEDICARE RAILROAD CARRIER
NJ
Enumeration date
07/18/2005
Last updated
09/21/2018
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