Healthcare Provider Details

I. General information

NPI: 1396864195
Provider Name (Legal Business Name): JOAN ELIZABETH DIOS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 STEVEN DR
NORTHFIELD NJ
08225-1035
US

IV. Provider business mailing address

2130 STEVEN DR
NORTHFIELD NJ
08225-1035
US

V. Phone/Fax

Practice location:
  • Phone: 609-407-1931
  • Fax:
Mailing address:
  • Phone: 609-407-1931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number26NO11104600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: