Individual
JOANNE BETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
350 ENGLE ST, ENGLEWOOD, NJ 07631-1808
(201) 894-3322
(201) 894-0585
Mailing address
375 ENGLE ST, SECOND FLOOR, ENGLEWOOD, NJ 07631-1823
(201) 871-6073
(201) 655-6159
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA04166300
NJ
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
25MA04166300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00508769
—
NY
01
—
050020586
RAILROAD MEDICARE
NJ
05
—
5525403
—
NJ
Enumeration date
05/16/2006
Last updated
08/18/2011
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