Healthcare Provider Details

I. General information

NPI: 1366414617
Provider Name (Legal Business Name): JENNIFER L. STONE M.S., C.G.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER L. KEENAN M.S., C.G.C.

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 11/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 COOPER PLZ SUITE 309
CAMDEN NJ
08103-1438
US

IV. Provider business mailing address

1 FEDERAL ST STE SW200
CAMDEN NJ
08103-1155
US

V. Phone/Fax

Practice location:
  • Phone: 856-968-7248
  • Fax: 856-541-6213
Mailing address:
  • Phone: 856-356-4924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number93075
License Number State
# 2
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number25MJ00006400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: