Individual
JESSICA FAKEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
130 SPEEDWELL AVE, MORRIS PLAINS, NJ 07950-2315
(862) 242-8053
Mailing address
203 GIBSON BLVD APT 8, CLARK, NJ 07066-1447
(732) 744-4024
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00434500
NJ
Other
Enumeration date
06/14/2017
Last updated
06/14/2017
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