Individual
DR. JENNIFER RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
466 OLD HOOK ROAD, SUITE 1, EMERSON, NJ 07630-1368
(201) 961-8221
(201) 634-9647
Mailing address
466 OLD HOOK ROAD, SUITE 1, EMERSON, NJ 07630-1368
(201) 967-8221
(201) 634-9647
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA08874400
NJ
390200000X
Student in an Organized Health Care Education/Training Program
25MA08874400
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/21/2009
Last updated
12/14/2012
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