Healthcare Provider Details

I. General information

NPI: 1285675090
Provider Name (Legal Business Name): CHARLES ALAN JOSEPH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 02/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 SPEEDWELL AVE
MORRIS PLAINS NJ
07950-2124
US

IV. Provider business mailing address

PO BOX 95000 LB# 7550
PHILADELPHIA PA
19195-7550
US

V. Phone/Fax

Practice location:
  • Phone: 973-267-9899
  • Fax: 973-538-3522
Mailing address:
  • Phone: 844-362-1735
  • Fax: 973-290-7495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA03343100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: