Provider Demographics
NPI:1245639079
Name:PADULA, JOY
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:PADULA
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 1:10 MARLBORO PL
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-3542
Mailing Address - Country:US
Mailing Address - Phone:516-728-4336
Mailing Address - Fax:
Practice Address - Street 1:10 MARLBORO PL
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-3542
Practice Address - Country:US
Practice Address - Phone:516-728-4336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-18
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY487104-1163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant