Healthcare Provider Details

I. General information

NPI: 1528329158
Provider Name (Legal Business Name): JOSEPH CHRISTOPHER DEMARCO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2012
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 PARK AVE
FLORHAM PARK NJ
07932
US

IV. Provider business mailing address

711 TROY SCHENECTADY RD SUITE 203
LATHAM NY
12110-2442
US

V. Phone/Fax

Practice location:
  • Phone: 734-372-6009
  • Fax: 973-660-1838
Mailing address:
  • Phone: 518-782-3700
  • Fax: 518-782-3799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number25MB10294600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MB10294600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: