Provider Demographics
NPI:1811959232
Name:DOWNIE, JEANINE B (M D)
Entity type:Individual
Prefix:DR
First Name:JEANINE
Middle Name:B
Last Name:DOWNIE
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 PARK ST
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-3439
Mailing Address - Country:US
Mailing Address - Phone:973-509-6900
Mailing Address - Fax:973-509-6939
Practice Address - Street 1:51 PARK ST
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-3439
Practice Address - Country:US
Practice Address - Phone:973-509-6900
Practice Address - Fax:973-509-6939
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA65931207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG51843Medicare UPIN
NJ951568Medicare PIN