Provider Demographics
NPI:1245263144
Name:DEMOSS, JEANNE L (DO)
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:L
Last Name:DEMOSS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:593 CRANBURY RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4093
Mailing Address - Country:US
Mailing Address - Phone:732-390-3333
Mailing Address - Fax:732-390-9244
Practice Address - Street 1:593 CRANBURY RD
Practice Address - Street 2:SUITE 2
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4093
Practice Address - Country:US
Practice Address - Phone:732-390-3333
Practice Address - Fax:732-390-9244
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA05848500207RC0000X
NJ25MB05848500207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ520797Medicare PIN
F88886Medicare UPIN