Healthcare Provider Details

I. General information

NPI: 1568801462
Provider Name (Legal Business Name): JOSHUA EWELL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2013
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 INGOLD DR
DIX HILLS NY
11746-7804
US

IV. Provider business mailing address

8 THE GRN STE R
DOVER DE
19901-3618
US

V. Phone/Fax

Practice location:
  • Phone: 888-890-0690
  • Fax:
Mailing address:
  • Phone: 888-890-0690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number277993
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: