Provider Demographics
NPI:1134775299
Name:UVA, JOAN G
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:G
Last Name:UVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 GREENWAYS LANE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-7501
Mailing Address - Country:US
Mailing Address - Phone:732-262-0841
Mailing Address - Fax:
Practice Address - Street 1:38 GREENWAYS LANE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-7501
Practice Address - Country:US
Practice Address - Phone:732-262-0841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider