Healthcare Provider Details

I. General information

NPI: 1053297671
Provider Name (Legal Business Name): JACQUELINE FRANCES RECCOPPA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 RANDOLPH RD
PLAINFIELD NJ
07060-3317
US

IV. Provider business mailing address

671 HOES LN W
PISCATAWAY NJ
08854-8021
US

V. Phone/Fax

Practice location:
  • Phone: 732-235-4944
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL07283200
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: