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NPI Code Detail

MEDICARE: DR. MARK C JOSEPH M.D.

MEDICARE:  DR. MARK C JOSEPH  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QA0505XAdult Medicine Physician215069NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053479816
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK C JOSEPH M.D.
Provider Business Mailing Address
First Line : 54 LAFAYETTE PL
Second Line :
City : WOODMERE
State : NY
Zip : 11598-2138
Country : US
Telephone Number : 516-374-8759
Fax Number :
Provider Business Practice Location Address
First Line : 1509 ROCKAWAY PKWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11236
Country : US
Telephone Number : 718-927-0027
Fax Number : 516-791-6529
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2006
Last Update Date : 03/11/2009

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