Provider Demographics
NPI:1275825382
Name:CADET, JENNIE R
Entity Type:Individual
Prefix:MRS
First Name:JENNIE
Middle Name:R
Last Name:CADET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 PRESTON ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-2268
Mailing Address - Country:US
Mailing Address - Phone:973-280-7577
Mailing Address - Fax:
Practice Address - Street 1:79 PRESTON ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-2268
Practice Address - Country:US
Practice Address - Phone:973-280-7577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-07
Last Update Date:2011-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist