Provider Demographics
NPI:1629103189
Name:TOTH, JACQUELINE (APN-C)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:
Last Name:TOTH
Suffix:
Gender:F
Credentials:APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 ALEXANDER DR
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-3004
Mailing Address - Country:US
Mailing Address - Phone:609-652-0100
Mailing Address - Fax:609-652-7616
Practice Address - Street 1:76 W JIMMIE LEEDS RD
Practice Address - Street 2:SUITE 201
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9411
Practice Address - Country:US
Practice Address - Phone:609-652-0100
Practice Address - Fax:609-652-7616
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR05629500363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health