Healthcare Provider Details

I. General information

NPI: 1083817233
Provider Name (Legal Business Name): JOANNE AFFINITO RN, MSN, APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 BROWNSTONE TER
HAWTHORNE NJ
07506-3447
US

IV. Provider business mailing address

20 BROWNSTONE TER
HAWTHORNE NJ
07506-3447
US

V. Phone/Fax

Practice location:
  • Phone: 201-602-8374
  • Fax:
Mailing address:
  • Phone: 201-602-8374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NN04855100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: