Provider Demographics
NPI:1356077457
Name:BOISON, JOYCELYN A
Entity Type:Individual
Prefix:
First Name:JOYCELYN
Middle Name:A
Last Name:BOISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 E SEDGWICK ST
Mailing Address - Street 2:
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-1211
Mailing Address - Country:US
Mailing Address - Phone:862-224-9458
Mailing Address - Fax:
Practice Address - Street 1:54 E SEDGWICK ST
Practice Address - Street 2:
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-1211
Practice Address - Country:US
Practice Address - Phone:862-224-9458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-29
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR20811700163W00000X
NJ26NJ01398200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse