Provider Demographics
NPI:1649201112
Name:PRUZON, JOANNA D (DO)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:D
Last Name:PRUZON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 PAVONIA AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-2929
Mailing Address - Country:US
Mailing Address - Phone:201-963-5846
Mailing Address - Fax:201-963-8823
Practice Address - Street 1:600 PAVONIA AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-2929
Practice Address - Country:US
Practice Address - Phone:201-963-5846
Practice Address - Fax:201-963-8823
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08072000207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology