Provider Demographics
NPI:1154306868
Name:JACQUES, JEAN ROBERT HARRY (MD)
Entity Type:Individual
Prefix:DR
First Name:JEAN ROBERT
Middle Name:HARRY
Last Name:JACQUES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:26 FOREST CT S
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-3123
Mailing Address - Country:US
Mailing Address - Phone:732-213-8978
Mailing Address - Fax:732-940-0965
Practice Address - Street 1:451 CLARKSON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2057
Practice Address - Country:US
Practice Address - Phone:718-245-2743
Practice Address - Fax:718-270-1438
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2015-03-27
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Provider Licenses
StateLicense IDTaxonomies
NY1844862084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry