Provider Demographics
NPI:1538208962
Name:JOSEPH, DIONNE J (FNP)
Entity type:Individual
Prefix:MS
First Name:DIONNE
Middle Name:J
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:163 MANHATTAN AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-6134
Mailing Address - Country:US
Mailing Address - Phone:201-862-9690
Mailing Address - Fax:
Practice Address - Street 1:6 EDGECOMBE AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-2432
Practice Address - Country:US
Practice Address - Phone:212-926-4171
Practice Address - Fax:212-926-4123
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336121363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP18883Medicare UPIN