Provider Demographics
NPI:1710984885
Name:NORONHA, JOAQUIM L (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAQUIM
Middle Name:L
Last Name:NORONHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1553 HIGHWAY 27
Mailing Address - Street 2:SUITE 3000
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-3980
Mailing Address - Country:US
Mailing Address - Phone:732-545-5980
Mailing Address - Fax:
Practice Address - Street 1:1553 HIGHWAY 27
Practice Address - Street 2:SUITE 3000
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3980
Practice Address - Country:US
Practice Address - Phone:732-545-5980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2010-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03374700207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
C56207Medicare UPIN