Provider Demographics
NPI:1952171290
Name:LIVINGSTONE, JOAN (RN)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:
Last Name:LIVINGSTONE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 12TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3830
Mailing Address - Country:US
Mailing Address - Phone:718-965-7910
Mailing Address - Fax:
Practice Address - Street 1:25 12TH ST STE 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3830
Practice Address - Country:US
Practice Address - Phone:718-965-7910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY547590-1163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)