Individual
OLGA JOSEPHINE JACQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
260 E 188TH ST, BRONX, NY 10458-5302
(718) 960-9000
Mailing address
260 E 188TH ST, BRONX, NY 10458-5302
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
299595
NY
Other
Enumeration date
05/16/2016
Last updated
09/30/2019
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