Basic Information
| Provider Information | |||||||||
| NPI: | 1467764464 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JENKINS | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1006 MANTUA PIKE | ||||||||
| Address2: | |||||||||
| City: | WOODBURY HEIGHTS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080971221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8568456880 | ||||||||
| FaxNumber: | 8568454890 | ||||||||
| Practice Location | |||||||||
| Address1: | 1006 MANTUA PIKE | ||||||||
| Address2: | |||||||||
| City: | WOODBURY HEIGHTS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080971221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8568456880 | ||||||||
| FaxNumber: | 8568454890 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2010 | ||||||||
| LastUpdateDate: | 11/15/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 25MA09643800 | NJ | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.