Provider Demographics
NPI:1043701253
Name:CRINCOLI, JOANNA (DO)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:CRINCOLI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FRANCES ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07014-1305
Mailing Address - Country:US
Mailing Address - Phone:973-902-4449
Mailing Address - Fax:
Practice Address - Street 1:10 FRANCES ST FL 2
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07014-1305
Practice Address - Country:US
Practice Address - Phone:973-902-4449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB111207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine