Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 25MA03016700 | NJ |
NPI | 1104228139 |
---|---|
Provider Name | Dr. Joyce Diane Moscaritola |
First Address | Randolph, NJ 07869 |
Second Address | Randolph, NJ 07869 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2014 |
Last Update Date | 22/09/2014 |