Provider Demographics
NPI: | 1639495260 |
---|---|
Name: | LING, JOYCE (CDE) |
Entity Type: | Individual |
Prefix: | MS |
First Name: | JOYCE |
Middle Name: | |
Last Name: | LING |
Suffix: | |
Gender: | F |
Credentials: | CDE |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 389 WASHINGTON ST APT 10A |
Mailing Address - Street 2: | |
Mailing Address - City: | JERSEY CITY |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 07302-8959 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 917-837-3087 |
Mailing Address - Fax: | 212-385-6081 |
Practice Address - Street 1: | 268 CANAL ST FL 4 |
Practice Address - Street 2: | |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10013-3599 |
Practice Address - Country: | US |
Practice Address - Phone: | 917-837-3087 |
Practice Address - Fax: | 212-385-6081 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2010-04-07 |
Last Update Date: | 2010-04-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 493495-01 | 163W00000X |
NJ | 26NR13674100 | 163W00000X |
NY | 2092-0587 | 163WD0400X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 163WD0400X | Nursing Service Providers | Registered Nurse | Diabetes Educator |
No | 163W00000X | Nursing Service Providers | Registered Nurse |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NJ | 26NR13674100 | Other | NJS-RN LICENSE |
NY | 493495-01 | Other | NYS-RN LICENSE |