Hollywood, Jacqueline
Hollywood, Jacqueline is an individual health care provider with primary practice located at 2200 Fletcher Ave , Fort Lee NJ 07024-5005. She recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as her primary health care specialty. Hollywood, Jacqueline can be contacted via phone (201) 461-6200.Contact Information
Primary practice address
2200 Fletcher Ave
Fort Lee NJ 07024-5005
Phone: (201) 461-6200
Fax: (201) 461-7204
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 25MA07427900 | New Jersey |
Profile Details
| NPI number | 1770589608 |
|---|---|
| LBN Legal business name | Hollywood, Jacqueline |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2005 |
| Last updated | Jun 25th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770589608 | NPPES |
| New Jersey | MEDICAID | 2620901 |
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