Provider Demographics
NPI:1588707871
Name:PARTRIDGE, JOANNA L (MD)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:L
Last Name:PARTRIDGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-0127
Mailing Address - Country:US
Mailing Address - Phone:609-918-1973
Mailing Address - Fax:
Practice Address - Street 1:213 N CENTER DR
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-4246
Practice Address - Country:US
Practice Address - Phone:609-918-1973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1376686683OtherGROUP NPI
NJ095523UQRMedicare PIN
NJI44476Medicare UPIN