Healthcare Provider Details

I. General information

NPI: 1932692704
Provider Name (Legal Business Name): PRIYA BIJU JOSEPH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2018
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 TEANECK RD
TEANECK NJ
07666-4245
US

IV. Provider business mailing address

159 3RD ST
BERGENFIELD NJ
07621-1439
US

V. Phone/Fax

Practice location:
  • Phone: 201-833-3210
  • Fax:
Mailing address:
  • Phone: 201-873-6023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number035166
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00475200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: