Individual
J MONIQUE JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
630 E RIVER ST, 4TH FLOOR PATHOLOGY DEPT, ELYRIA, OH 44035-5902
(440) 329-7656
Mailing address
630 E RIVER ST, 4TH FLOOR PATHOLOGY DEPT, ELYRIA, OH 44035-5902
(440) 329-7656
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
35068944
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0239889
—
OH
Enumeration date
05/08/2006
Last updated
02/23/2015
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