Healthcare Provider Details

I. General information

NPI: 1962367243
Provider Name (Legal Business Name): JOSHUA JORGE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 E MAIN ST
NORTON MA
02766-2310
US

IV. Provider business mailing address

371 CASWELL ST
EAST TAUNTON MA
02718-1121
US

V. Phone/Fax

Practice location:
  • Phone: 508-285-0240
  • Fax:
Mailing address:
  • Phone: 617-685-1445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberP0902335
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: