Dr JACLYN ANNE FUDALA is a female medical professional, specializing in Physician Assistant. She graduated in 2017.
HACKENSACK UNIVERSITY MEDICAL GROUP PC
30 PROSPECT AVE
HACKENSACK
NJ
076011915
Tel: 5519965045
| Npi | 1013422856 |
| Pac Id | 2860757374 |
| Professional Enrollment Id | I20180605000950 |
| Last Name | FUDALA |
| First Name | JACLYN |
| Middle Name | ANNE |
| Suffix | |
| Gender | F |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 2017 |
| Primary Specialty | PHYSICIAN ASSISTANT |
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| Organization Legal Name | HACKENSACK UNIVERSITY MEDICAL GROUP PC |
| Group Practice Pac Id | 9133032519 |
| Number Of Group Practice Members | 233 |
| Line 1 Street Address | 30 PROSPECT AVE |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | HACKENSACK |
| State | NJ |
| Zip Code | 076011915 |
| Phone Number | 5519965045 |
| Hospital Affiliation Ccn 1 | 310001 |
| Hospital Affiliation Lbn 1 | HACKENSACK UNIVERSITY MEDICAL CENTER |
| Hospital Affiliation Ccn 2 | |
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| Professional Accepts Medicare Assignment | Y |
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