Individual
JACQUELINE YSIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
714 10TH ST, SECAUCUS, NJ 07094-2921
(201) 865-2050
Mailing address
714 10TH ST, SECAUCUS, NJ 07094-2921
(201) 865-2050
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA09573400
NJ
Other
Enumeration date
08/07/2014
Last updated
12/14/2016
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