Provider Demographics
NPI:1083027684
Name:DINTINO, JOANNE M
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:M
Last Name:DINTINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:M
Other - Last Name:BLACK-D'INTINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:223 44TH ST
Mailing Address - Street 2:
Mailing Address - City:SEA ISLE CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08243-1805
Mailing Address - Country:US
Mailing Address - Phone:609-425-3513
Mailing Address - Fax:
Practice Address - Street 1:1332 50 WEST AVE
Practice Address - Street 2:
Practice Address - City:OCEAN CITY
Practice Address - State:NJ
Practice Address - Zip Code:08226
Practice Address - Country:US
Practice Address - Phone:609-814-1954
Practice Address - Fax:609-814-0720
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02246600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist