Healthcare Provider Details

I. General information

NPI: 1407436835
Provider Name (Legal Business Name): JENNA MARIE GUMA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2021
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 PROSPECT AVE STE 204
HACKENSACK NJ
07601-2570
US

IV. Provider business mailing address

385 PROSPECT AVE STE 204
HACKENSACK NJ
07601-2570
US

V. Phone/Fax

Practice location:
  • Phone: 551-996-9244
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: