Organization
CELESTE A. JACQUE MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN FRAGER (BILLING MANAGER)
(636) 464-8422
Entity
Organization
Contact information
Practice address
201 S LIVINGSTON AVE, SUITE 1A, LIVINGSTON, NJ 07039-4043
(973) 994-1500
(973) 994-1606
Mailing address
201 S LIVINGSTON AVE, SUITE 1A, LIVINGSTON, NJ 07039-4043
(973) 994-1500
(973) 994-1606
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MA042633
NJ
Other
Enumeration date
03/11/2008
Last updated
03/11/2008
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