MEDICARE: SURESH JOSHI PHYSICIAN P.C.

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	208D00000X	General Practice Physician	140703	NY

General Provider Information

NPI Number	:	1861424269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURESH JOSHI PHYSICIAN P.C.

Provider Business Mailing Address
First Line	:	3601 HEMPSTEAD TPKE
Second Line	:	SUITE 405
City	:	LEVITTOWN
State	:	NY
Zip	:	11756-1375
Country	:	US
Telephone Number	:	516-520-9800
Fax Number	:	516-520-9316

Provider Business Practice Location Address
First Line	:	3601 HEMPSTEAD TPKE
Second Line	:	SUITE 405
City	:	LEVITTOWN
State	:	NY
Zip	:	11756-1375
Country	:	US
Telephone Number	:	516-520-9800
Fax Number	:	516-520-9316

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. SURESH JOSHI
Credential	:	M.D.
Telephone Number	:	516-520-9800

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	08/22/2020

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