Provider Demographics
NPI:1639266638
Name:JARECKI, JENNIFER A (DO)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:JARECKI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:COOPER UNIVERSITY EMERGNECY PHYSICIANS
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-2930
Practice Address - Fax:856-968-8272
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB65945207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0644437000OtherAMERIHEALTH/KEYSTONE/IBC
NJ18402OtherUNIVERSITY HEALTH PLAN
NJ3551680OtherAETNA
NJ4652315OtherCIGNA
NJ60005670OtherHORIZON NJ HEALTH
NJ010006259 00OtherAMERICHOICE
NJ766404OtherAMERIHEALTH PPO/PA BS
NJP3345592OtherOXFORD
NJ2151162OtherUNITED HEALTHCARE
NY02660108Medicaid
NJ7978405Medicaid
NJ3551680OtherAETNA
NJ7978405Medicaid
NJ010006259 00OtherAMERICHOICE