Provider Demographics
NPI:1972598829
Name:PARCHMENT, WINSOME JOAN (MD)
Entity Type:Individual
Prefix:MRS
First Name:WINSOME
Middle Name:JOAN
Last Name:PARCHMENT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1973 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-3435
Mailing Address - Country:US
Mailing Address - Phone:973-313-2501
Mailing Address - Fax:973-313-2505
Practice Address - Street 1:1973 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3435
Practice Address - Country:US
Practice Address - Phone:973-313-2501
Practice Address - Fax:973-313-2505
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-16
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA57510174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6300502Medicaid
NJ6300502Medicaid
NJ6300502Medicaid