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General NPI Number Information
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NPI Number | 1699140376
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Entity Type | Individual
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Provider Name | LISA ANN JOSEPH DPT
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Gender | Female
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Dates
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Enumeration Date | 12/07/2015
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Last Update Date | 12/07/2015
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Provider Practice Location Address
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Address Line | 12406 14TH AVE
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City | COLLEGE POINT
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State | NY
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Zip | 11356-1802
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Country | US
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Telephone | 516-507-2382
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Fax |
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Provider Business Mailing Address
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Address Line | 65 WARWICK RD
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City | ELMONT
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State | NY
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Zip | 11003-1425
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Country | US
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Telephone | 516-507-2382
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 039587
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License Number State | NY
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