Healthcare Provider Details

I. General information

NPI: 1598757205
Provider Name (Legal Business Name): JOSHUA DAVID HOTTENSTEIN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 BUFFALO RD STE 207
LEWISBURG PA
17837-1151
US

IV. Provider business mailing address

130 BUFFALO RD STE 207
LEWISBURG PA
17837-1151
US

V. Phone/Fax

Practice location:
  • Phone: 570-908-4053
  • Fax: 570-755-7077
Mailing address:
  • Phone: 570-908-4053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD425463
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: