Provider Demographics
NPI:1811086879
Name:LEONETTI, JOYCE DIANE (DO, MPH)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:DIANE
Last Name:LEONETTI
Suffix:
Gender:F
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HARKER AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-2331
Mailing Address - Country:US
Mailing Address - Phone:856-767-0017
Mailing Address - Fax:
Practice Address - Street 1:7 HARKER AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08009-2331
Practice Address - Country:US
Practice Address - Phone:856-767-0017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB041055002083A0100X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
Not Answered2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE06149Medicare UPIN