Healthcare Provider Details

I. General information

NPI: 1043669021
Provider Name (Legal Business Name): JOJO JOSEPH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 WESTCHESTER AVE STE 120
BRONX NY
10461-4500
US

IV. Provider business mailing address

122 SMITH HILL RD
SUFFERN NY
10901-7735
US

V. Phone/Fax

Practice location:
  • Phone: 718-414-2601
  • Fax: 718-710-4343
Mailing address:
  • Phone: 845-893-7002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME145081
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: