Jacqueline Smith, MD PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

25MA09182300 Issued in NJ

Legal business name

JACQUELINE SMITH, MD PC

Practice address

716 Broad St
Suite 2a
Clifton, NJ 07013-1645

Phone

(973) 221-3122

Fax

(973) 710-0620

NPI assigned

Dec 6, 2013

Last updated

Dec 6, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Cynthia Acevedo

Title

Credentialing Specialist

Phone

(973) 928-3341

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386288000000",
    "number": "1790116374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 BROAD STREET",
            "address_2": "SUITE 2A",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131607",
            "telephone_number": "973-221-3122",
            "fax_number": "973-710-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 BROAD ST",
            "address_2": "SUITE 2A",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131645",
            "telephone_number": "973-221-3122",
            "fax_number": "973-710-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELINE SMITH, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-06",
        "last_updated": "2013-12-06",
        "status": "A",
        "authorized_official_last_name": "ACEVEDO",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "973-928-3341",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA09182300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0310981",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edith J. Jackson, NP-C
• Ariel Isaiah Jacob, DO
• Shobha Jacob, MS OTR CHT
• Jeffrey Michael Jacobs, DPM
• Sharon Lea Jacobsen, MA LPC
• Thomas Jaeger, PHARMD.
• Tyeisha A James, MSN, RNC-MNN, IBCLC
• Chandrasekaran Janakiraman, MD
• Nart Janouk
• Amanda Januszanis

• Obstetrics & Gynecology Physician in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Obstetrics & Gynecology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.