Provider Demographics
NPI:1477205383
Name:OREST, JACQUELINE (DC)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:
Last Name:OREST
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 BLOOMFIELD AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2735
Mailing Address - Country:US
Mailing Address - Phone:973-441-1765
Mailing Address - Fax:
Practice Address - Street 1:75 BLOOMFIELD AVE STE 202
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2735
Practice Address - Country:US
Practice Address - Phone:973-441-1765
Practice Address - Fax:973-398-4552
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00788800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty