Individual
JODLEEN DORICENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
36 1ST AVE, BOSTON, MA 02129-4557
(617) 726-2947
Mailing address
331 NEWMAN SPRINGS RD STE 220, RED BANK, NJ 07701-5792
(732) 807-0877
(201) 751-1680
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00603800
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2020
Last updated
12/05/2024
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