Provider Demographics
NPI:1417772286
Name:OZAWA-MORRIELLO, JOSHUA (MSN, RN, FNP-BC)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:OZAWA-MORRIELLO
Suffix:
Gender:M
Credentials:MSN, RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 INTERGLEN AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER VALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-6222
Mailing Address - Country:US
Mailing Address - Phone:201-394-5352
Mailing Address - Fax:
Practice Address - Street 1:370 GRAND AVE STE 102
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4109
Practice Address - Country:US
Practice Address - Phone:201-567-3370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF355443-01363LF0000X
NJ26NJ15212500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily