Basic Information
| Provider Information | |||||||||
| NPI: | 1083641153 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOONEY | ||||||||
| FirstName: | JOYCE | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1087 DARK MOON ROAD | ||||||||
| Address2: | |||||||||
| City: | NEWTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07860 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9089791451 | ||||||||
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| Practice Location | |||||||||
| Address1: | 50 POCONO RD | ||||||||
| Address2: | |||||||||
| City: | DENVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 078342957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9736256000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | 26NO07236000 | NJ | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.