Healthcare Provider Details

I. General information

NPI: 1528109584
Provider Name (Legal Business Name): JOANNE MARIE MORIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

939 PARK AVE
PLAINFIELD NJ
07060-3001
US

IV. Provider business mailing address

10 FREDERICK PL
SPARTA NJ
07871-3907
US

V. Phone/Fax

Practice location:
  • Phone: 908-226-5445
  • Fax: 908-226-5481
Mailing address:
  • Phone: 973-362-1023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMA072756
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: