MEDICARE: DR. MITCHELL JOSEPHS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	194981-1	NY
2	207RG0100X	Gastroenterology Physician	194981	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063413532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHELL JOSEPHS M.D.

Provider Business Mailing Address
First Line	:	64 UNDERHILL RD
Second Line	:
City	:	OSSINING
State	:	NY
Zip	:	10562-5104
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1985 CROMPOND RD
Second Line	:	BUILDING D
City	:	CORTLANDT MANOR
State	:	NY
Zip	:	10567-4146
Country	:	US
Telephone Number	:	914-739-2400
Fax Number	:	914-739-2691

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	03/12/2018

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