Provider Demographics
NPI:1184807372
Name:MAMARIL, JOSEPHINE CELI (APN, C)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:CELI
Last Name:MAMARIL
Suffix:
Gender:F
Credentials:APN, C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 JOANNE WAY
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1921
Mailing Address - Country:US
Mailing Address - Phone:973-379-7876
Mailing Address - Fax:
Practice Address - Street 1:30 JOANNE WAY
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1921
Practice Address - Country:US
Practice Address - Phone:973-379-7876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00021700363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health