Healthcare Provider Details

I. General information

NPI: 1790330934
Provider Name (Legal Business Name): JOSHI JOHN PSYCHIATRY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2019
Last Update Date: 08/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 KRISTI DRIVE
JERICHO NY
11753-1309
US

IV. Provider business mailing address

26 KRISTI DRIVE
JERICHO NY
11753-1309
US

V. Phone/Fax

Practice location:
  • Phone: 516-708-3291
  • Fax:
Mailing address:
  • Phone: 516-822-0241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSHI JOHN
Title or Position: OWNER
Credential: MD
Phone: 516-708-3291