Organization
JACQUELINE SMITH, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CYNTHIA ACEVEDO (CREDENTIALING SPECIALIST)
(973) 928-3341
Entity
Organization
Contact information
Practice address
716 BROAD ST, SUITE 2A, CLIFTON, NJ 07013-1645
(973) 221-3122
(973) 710-0620
Mailing address
716 BROAD STREET, SUITE 2A, CLIFTON, NJ 07013-1607
(973) 221-3122
(973) 710-0620
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25MA09182300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0310981
—
NJ
Enumeration date
12/06/2013
Last updated
12/06/2013
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