Provider Demographics
NPI:1598416828
Name:MERCED, JOYSKA MARIE
Entity Type:Individual
Prefix:
First Name:JOYSKA
Middle Name:MARIE
Last Name:MERCED
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 685
Mailing Address - Street 2:
Mailing Address - City:ISLAND HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08732-0685
Mailing Address - Country:US
Mailing Address - Phone:845-275-5438
Mailing Address - Fax:
Practice Address - Street 1:319 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:SEASIDE HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08751-2427
Practice Address - Country:US
Practice Address - Phone:845-275-5438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-18
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJM26604157453882343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)