Healthcare Provider Details

I. General information

NPI: 1639495260
Provider Name (Legal Business Name): JOYCE LING CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2010
Last Update Date: 04/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

268 CANAL ST FL 4
NEW YORK NY
10013-3599
US

IV. Provider business mailing address

389 WASHINGTON ST APT 10A
JERSEY CITY NJ
07302-8959
US

V. Phone/Fax

Practice location:
  • Phone: 917-837-3087
  • Fax: 212-385-6081
Mailing address:
  • Phone: 917-837-3087
  • Fax: 212-385-6081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number493495-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR13674100
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number2092-0587
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: