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General NPI Number Information
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NPI Number | 1609611672
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Entity Type | Individual
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Provider Name | ZOE MARIE DEAKYNE
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Gender | Female
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Dates
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Enumeration Date | 07/01/2024
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 65 W JIMMIE LEEDS RD
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City | POMONA
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State | NJ
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Zip | 08240-9102
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Country | US
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Telephone | 609-661-3486
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 LUDLOW ST APT 803
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4261
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Country | US
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Telephone | 609-661-3486
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00976200
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License Number State | NJ
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