Provider Demographics
NPI:1407979552
Name:SIMONE, JOSEPH T (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:T
Last Name:SIMONE
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 OAK HILL RD
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5727
Mailing Address - Country:US
Mailing Address - Phone:732-741-2313
Mailing Address - Fax:732-741-7154
Practice Address - Street 1:80 OAK HILL RD
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5727
Practice Address - Country:US
Practice Address - Phone:732-741-2313
Practice Address - Fax:732-741-7154
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00506900111N00000X
NY38MC00506900111N00000X
NJ26NJ00447700363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU67263Medicare UPIN