Provider Demographics
NPI:1760202691
Name:EON CARE CLINICIANS OF NJ, PC
Entity type:Organization
Organization Name:EON CARE CLINICIANS OF NJ, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:667-218-3396
Mailing Address - Street 1:20451 SENECA MEADOWS PKWY
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-7005
Mailing Address - Country:US
Mailing Address - Phone:301-515-7260
Mailing Address - Fax:202-478-5119
Practice Address - Street 1:20451 SENECA MEADOWS PKWY
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-7005
Practice Address - Country:US
Practice Address - Phone:301-515-2760
Practice Address - Fax:202-478-5119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-15
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty