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Individual

RONALD JACQUES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
3009 GLENWOOD RD, BROOKLYN, NY 11210-2641
(718) 421-1003
(718) 434-0445
Mailing address
10 EDSON LN, GLEN HEAD, NY 11545-2502
(516) 669-1329

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
155412
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00930314
NY
Enumeration date
01/20/2006
Last updated
02/14/2012
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