Individual
JOELLE MCCONLOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
254 EASTON AVE, NEW BRUNSWICK, NJ 08901-1766
(732) 745-8519
(732) 220-0659
Mailing address
254 EASTON AVE, NEW BRUNSWICK, NJ 08901-1766
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
C139774
CA
208000000X
Pediatrics Physician
Primary
MA72237
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8216509
—
NJ
Enumeration date
07/27/2006
Last updated
02/29/2016
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