Provider Demographics
NPI:1033133343
Name:JOSEPH, SATHEESH (MD)
Entity Type:Individual
Prefix:
First Name:SATHEESH
Middle Name:
Last Name:JOSEPH
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 1:325 E MAIN ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-3114
Mailing Address - Country:US
Mailing Address - Phone:631-654-3278
Mailing Address - Fax:631-654-1474
Practice Address - Street 1:325 E MAIN ST
Practice Address - Street 2:SUITE 120
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-3114
Practice Address - Country:US
Practice Address - Phone:631-654-3278
Practice Address - Fax:631-654-1474
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY222332207RI0011X, 207RM1200X, 207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RM1200XAllopathic & Osteopathic PhysiciansInternal MedicineMagnetic Resonance Imaging (MRI)
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02780909Medicaid
NY729P11OtherEMPIRE BLUE CROSS BLUE SHIELD
NY729P11Medicare PIN
NY02780909Medicaid