Provider Demographics
NPI:1043223027
Name:SIEGRIST, JOY HELENE (MD)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:HELENE
Last Name:SIEGRIST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12222 CREEK EDGE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-6500
Mailing Address - Country:US
Mailing Address - Phone:914-260-4411
Mailing Address - Fax:813-654-6453
Practice Address - Street 1:12222 CREEK EDGE DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-6500
Practice Address - Country:US
Practice Address - Phone:914-260-4411
Practice Address - Fax:813-654-6453
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME565842084P0800X, 2084P0804X, 2084P0805X
NY226225-12084P0804X, 2084P0805X
CAA433402084P0804X, 2084P0800X, 2084P0805X
NY2262252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000272100Medicaid
FL000272100Medicaid
FLAL550AMedicare PIN