Provider Demographics
NPI:1528817111
Name:PACIUS-JOSEPH, CLAIREMEDA
Entity type:Individual
Prefix:
First Name:CLAIREMEDA
Middle Name:
Last Name:PACIUS-JOSEPH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CLAIREMEDA
Other - Middle Name:
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PMHNP
Mailing Address - Street 1:415 SWEENEY AVE
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-2184
Mailing Address - Country:US
Mailing Address - Phone:732-403-6408
Mailing Address - Fax:
Practice Address - Street 1:415 SWEENEY AVE
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-2184
Practice Address - Country:US
Practice Address - Phone:732-403-6408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15031500163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health