Provider Demographics
NPI:1073786737
Name:GREGORY, JOSEFINA (ADV PRACTICE RN)
Entity Type:Individual
Prefix:
First Name:JOSEFINA
Middle Name:
Last Name:GREGORY
Suffix:
Gender:F
Credentials:ADV PRACTICE RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 CHARNWOOD RD
Mailing Address - Street 2:
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974-1768
Mailing Address - Country:US
Mailing Address - Phone:908-508-1344
Mailing Address - Fax:908-508-0033
Practice Address - Street 1:261 JAMES ST STE 1G
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6348
Practice Address - Country:US
Practice Address - Phone:973-540-9393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00000100363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NJ00000100OtherSTATE LICENSE