Provider Demographics
NPI:1447248422
Name:ECHO, JOYCE ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:ANN
Last Name:ECHO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 WOODCREST DR
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-3849
Mailing Address - Country:US
Mailing Address - Phone:973-454-5070
Mailing Address - Fax:
Practice Address - Street 1:120 EAGLE ROCK AVE STE 148
Practice Address - Street 2:
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-3168
Practice Address - Country:US
Practice Address - Phone:862-591-9819
Practice Address - Fax:973-251-9007
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ051-A237103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0070254Medicaid
NJ091713Medicare ID - Type Unspecified