Provider Demographics
NPI:1316252679
Name:DE JESUS, HECTOR
Entity type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:
Last Name:DE JESUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 WESTSIDE AVE
Mailing Address - Street 2:REAR
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-6502
Mailing Address - Country:US
Mailing Address - Phone:201-660-5720
Mailing Address - Fax:
Practice Address - Street 1:840 WESTSIDE AVE
Practice Address - Street 2:REAR
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-6502
Practice Address - Country:US
Practice Address - Phone:201-660-5720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor