Individual
JOY SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22-02 BROADWAY, FAIR LAWN, NJ 07410-3016
(551) 299-2900
Mailing address
10-12 SCOTT ST, NEWARK, NJ 07102-3492
(862) 902-3094
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ01407600
NJ
Other
Enumeration date
04/20/2023
Last updated
04/19/2024
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