Provider Demographics
NPI:1023178381
Name:SIEGEL, JOSHUA E (DC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:E
Last Name:SIEGEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 32
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-0032
Mailing Address - Country:US
Mailing Address - Phone:516-425-0113
Mailing Address - Fax:
Practice Address - Street 1:2439 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-3547
Practice Address - Country:US
Practice Address - Phone:516-425-0113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-09
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011276111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX6553YYQW1Medicare PIN