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General NPI Number Information
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NPI Number | 1518627306
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Entity Type | Organization
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Legal Business Name | JOSHUA SISSER, MD, P.C.
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Dates
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Enumeration Date | 12/21/2021
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 775 PARK AVE STE 225
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City | HUNTINGTON
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State | NY
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Zip | 11743-7532
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Country | US
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Telephone | 718-222-5999
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Fax | 718-387-6429
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Provider Business Mailing Address
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Address Line | 7103 170TH ST
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City | FRESH MEADOWS
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State | NY
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Zip | 11365-3333
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Country | US
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Telephone | 718-222-5999
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Fax | 718-387-6429
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Authorized Official
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Title or Position | CEO
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Name | JOSHUA SISSER
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Credential | MD
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Telephone | 718-222-5999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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