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General NPI Number Information
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NPI Number | 1710807888
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Entity Type | Individual
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Provider Name | JACQUELINE RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 49 MOUNT PLEASANT AVE
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City | WEST ORANGE
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State | NJ
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Zip | 07052-4901
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Country | US
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Telephone | 973-325-2266
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Fax |
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Provider Business Mailing Address
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Address Line | 2210 STELMASZEK RD
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City | PARLIN
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State | NJ
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Zip | 08859-3209
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Country | US
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Telephone | 732-407-3389
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 26NR24226400
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License Number State | NJ
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