Provider Demographics
NPI:1780354563
Name:MARIANI, JOCELYN PATRICIA (FNP-BC)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:PATRICIA
Last Name:MARIANI
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JOCELYN
Other - Middle Name:PATRICIA
Other - Last Name:MARIANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:112 PORTSIDE DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1147
Mailing Address - Country:US
Mailing Address - Phone:518-605-4214
Mailing Address - Fax:
Practice Address - Street 1:250 MOONACHIE RD STE 100
Practice Address - Street 2:
Practice Address - City:MOONACHIE
Practice Address - State:NJ
Practice Address - Zip Code:07074-1322
Practice Address - Country:US
Practice Address - Phone:201-596-6262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01202400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily