Provider Demographics
NPI:1467219493
Name:JOSEPH, JOMINA
Entity Type:Individual
Prefix:
First Name:JOMINA
Middle Name:
Last Name:JOSEPH
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:PO BOX 260603
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-0603
Mailing Address - Country:US
Mailing Address - Phone:786-487-3001
Mailing Address - Fax:
Practice Address - Street 1:2273 CHURCH AVE UNIT 260603
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-8139
Practice Address - Country:US
Practice Address - Phone:786-487-3001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula