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General NPI Number Information
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NPI Number | 1932365400
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Entity Type | Individual
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Provider Name | JOANN CARLSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/04/2008
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Last Update Date | 09/19/2014
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Provider Practice Location Address
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Address Line | 89 FRENCH ST
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-1935
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Country | US
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Telephone | 732-235-7880
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Fax | 732-235-6620
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Provider Business Mailing Address
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Address Line | 89 FRENCH ST
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-1935
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Country | US
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Telephone | 732-235-7880
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Fax | 732-235-6620
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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 | 2080P0210X
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Taxonomy Name | Pediatric Nephrology Physician
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License Number | 25MA09496800
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License Number State | NJ
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