Provider Demographics
NPI:1033117171
Name:DUFFY, JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:DUFFY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 HAMBURG TPKE
Mailing Address - Street 2:SUITE 14
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2110
Mailing Address - Country:US
Mailing Address - Phone:973-942-0200
Mailing Address - Fax:973-942-0202
Practice Address - Street 1:220 HAMBURG TPKE
Practice Address - Street 2:SUITE 14
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2110
Practice Address - Country:US
Practice Address - Phone:973-942-0200
Practice Address - Fax:973-942-0202
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05656700207P00000X
NJMA056567207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5070708Medicaid
NJ5070708Medicaid
NJF05760Medicare UPIN