Provider Demographics
NPI:1497565519
Name:JOSEPH, DEBORAH (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08083-1526
Mailing Address - Country:US
Mailing Address - Phone:609-413-0713
Mailing Address - Fax:
Practice Address - Street 1:1423 TILTON RD STE 6
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1857
Practice Address - Country:US
Practice Address - Phone:973-954-4592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-10
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15229900363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health