Provider Demographics
NPI:1063628360
Name:DESIPIO, JOSHUA PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:PETER
Last Name:DESIPIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:501 FELLOWSHIP RD
Practice Address - Street 2:SUITE 101
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-3419
Practice Address - Country:US
Practice Address - Phone:856-963-3572
Practice Address - Fax:856-338-9211
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08241400207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
45067OtherUNIVERSITY HEALTHPLAN
60036692OtherHORIZON NJ HEALTH
010045951OtherAMERICHOICE
PA1979176OtherBLUE SHIELD
4493315OtherCIGNA
DE1635008OtherAETNA
NJ0139475Medicaid
NJ1635399OtherAETNA
NJ2621382000OtherAMERIHEALTH GRP#
DE235015400OtherAMERIHEALTH DELAWARE GRP#
P3821723OtherOXFORD
2858174000OtherAMERIHEALTH HMO, KEYSTONE, IBC
NJP00414121OtherRR MEDICARE
P3821723OtherOXFORD