Individual
DR. JENNIFER L BALOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D.
Contact information
Practice address
3020 HIGHWAY 35, HAZLET, NJ 07730-1505
(732) 739-2302
Mailing address
60 BROOKWOOD PKWY, JACKSON, NJ 08527-1809
(732) 766-5324
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI03080500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28RI03080500
—
NJ
Enumeration date
02/18/2008
Last updated
02/18/2008
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