Provider Demographics
NPI:1528796968
Name:ANSONG, JOYCE A
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:A
Last Name:ANSONG
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 1:35 BEAVER DAM DR
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-5673
Mailing Address - Country:US
Mailing Address - Phone:856-975-1727
Mailing Address - Fax:
Practice Address - Street 1:100 WEST AVE STE 910
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2642
Practice Address - Country:US
Practice Address - Phone:215-245-2131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN275328164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse