Provider Demographics
NPI:1528612587
Name:MARKISON, JOAN M (APN-FAMILY)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:MARKISON
Suffix:
Gender:F
Credentials:APN-FAMILY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MORVEN PL
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-3024
Mailing Address - Country:US
Mailing Address - Phone:609-213-9718
Mailing Address - Fax:
Practice Address - Street 1:22 MORVEN PL
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-3024
Practice Address - Country:US
Practice Address - Phone:609-213-9718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00928500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine