Provider Demographics
NPI:1427375179
Name:JENNY CAM M.D. PC
Entity Type:Organization
Organization Name:JENNY CAM M.D. PC
Other - Org Name:JENNY G. CAM, MD
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:G
Authorized Official - Last Name:CAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-656-6003
Mailing Address - Street 1:10 HURON AVE
Mailing Address - Street 2:SUITE 1P
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3641
Mailing Address - Country:US
Mailing Address - Phone:201-656-6003
Mailing Address - Fax:201-656-4566
Practice Address - Street 1:10 HURON AVE
Practice Address - Street 2:SUITE 1P
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3641
Practice Address - Country:US
Practice Address - Phone:201-656-6003
Practice Address - Fax:201-656-4566
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JENNY CAM M.D. PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3980600Medicaid
NJCA560945Medicare PIN
NJ3980600Medicaid