Provider Demographics
NPI:1891799474
Name:FELICIANO, JOYCE LYNN (NPC)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:LYNN
Last Name:FELICIANO
Suffix:
Gender:F
Credentials:NPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:470C LIBERTY ST
Mailing Address - Street 2:APT 312
Mailing Address - City:LITTLE FERRY
Mailing Address - State:NJ
Mailing Address - Zip Code:07643-1011
Mailing Address - Country:US
Mailing Address - Phone:201-440-8881
Mailing Address - Fax:201-288-2734
Practice Address - Street 1:288 BOULEVARD STE 2
Practice Address - Street 2:
Practice Address - City:HASBROUCK HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07604-1319
Practice Address - Country:US
Practice Address - Phone:201-288-6781
Practice Address - Fax:201-288-2734
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ069135363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily