Healthcare Provider Details

I. General information

NPI: 1205992575
Provider Name (Legal Business Name): JO ANN DUFFY RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 WATCHUNG WAY
BERKELEY HEIGHTS NJ
07922-2600
US

IV. Provider business mailing address

47 TROY DR
SPRINGFIELD NJ
07081-2002
US

V. Phone/Fax

Practice location:
  • Phone: 908-771-5926
  • Fax:
Mailing address:
  • Phone: 201-247-9396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number43ZA00125900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: