Healthcare Provider Details

I. General information

NPI: 1518774843
Provider Name (Legal Business Name): DEONNA JOYNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2024
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 CRESCENT AVE
PASSAIC NJ
07055-2437
US

IV. Provider business mailing address

886 SALEM DR
TOMS RIVER NJ
08753-3946
US

V. Phone/Fax

Practice location:
  • Phone: 973-264-0023
  • Fax:
Mailing address:
  • Phone: 732-644-6659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL07118900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: