Provider Demographics
NPI:1639230600
Name:JOYCE NKWONTA MD. PC.
Entity Type:Organization
Organization Name:JOYCE NKWONTA MD. PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:O
Authorized Official - Last Name:NKWONTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-561-9733
Mailing Address - Street 1:1314 PARK AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-3253
Mailing Address - Country:US
Mailing Address - Phone:908-561-9733
Mailing Address - Fax:
Practice Address - Street 1:1314 PARK AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-3253
Practice Address - Country:US
Practice Address - Phone:908-561-9733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA070887207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G53176Medicare UPIN