Provider Demographics
NPI:1851807085
Name:JOSEPH, REZIN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:REZIN
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-8828
Mailing Address - Country:US
Mailing Address - Phone:201-468-8888
Mailing Address - Fax:201-455-3083
Practice Address - Street 1:564 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-8828
Practice Address - Country:US
Practice Address - Phone:201-468-8888
Practice Address - Fax:201-455-3083
Is Sole Proprietor?:No
Enumeration Date:2017-12-26
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00774700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily