Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 215069 | NY |
NPI | 1053479816 |
---|---|
Provider Name | Dr. Mark C Joseph |
First Address | Woodmere, NY 11598-2138 |
Second Address | Brooklyn, NY 11236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 11/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02059052 | (05) | NY |
F62999 | (02) | NY |