Provider Demographics
NPI:1245071133
Name:LUONGO, JOANNA (PMHNP)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:LUONGO
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 MOUNTAIN RD APT 1402
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-7308
Mailing Address - Country:US
Mailing Address - Phone:646-773-8042
Mailing Address - Fax:
Practice Address - Street 1:380 MOUNTAIN RD APT 1402
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-7308
Practice Address - Country:US
Practice Address - Phone:646-773-8042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15082100363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health