Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NS0005X | Chiropractic Sports Physician | 3164 | NY |
Y | 111NS0005X | Chiropractic Sports Physician | X008088 | NY |
NPI | 1063509867 |
---|---|
Provider Name | Dr. Crystal A Joseph |
First Address | Tarrytown, NY 10591-5623 |
Second Address | New York, NY 10010-8119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 15/12/2021 |