Healthcare Provider Details

I. General information

NPI: 1053327338
Provider Name (Legal Business Name): JOSEPH M LAROSA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 CARE LN
SARATOGA SPRINGS NY
12866-8623
US

IV. Provider business mailing address

121 EVERETT RD
ALBANY NY
12205-1474
US

V. Phone/Fax

Practice location:
  • Phone: 518-489-2663
  • Fax: 518-689-3881
Mailing address:
  • Phone: 518-489-2663
  • Fax: 518-689-3881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number181747
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: