Provider Demographics
NPI:1013211879
Name:JOSEPH, JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JIMMY
Other - Middle Name:
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:970 NORTH BROADWAY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1310
Mailing Address - Country:US
Mailing Address - Phone:914-476-4343
Mailing Address - Fax:914-963-6426
Practice Address - Street 1:970 NORTH BROADWAY
Practice Address - Street 2:SUITE 204
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1310
Practice Address - Country:US
Practice Address - Phone:914-476-4343
Practice Address - Fax:914-963-6426
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-07
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253642390200000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program