Provider Demographics
NPI:1093757908
Name:JOSEPH, DAVID A (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:460 MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-2027
Mailing Address - Country:US
Mailing Address - Phone:607-432-3392
Mailing Address - Fax:607-432-3392
Practice Address - Street 1:460 MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-2027
Practice Address - Country:US
Practice Address - Phone:607-432-3392
Practice Address - Fax:607-432-3392
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2014-04-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYN004894213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNY01364603Medicaid
NYJ300068722Medicare PIN
NYU40054Medicare UPIN
NYNY01364603Medicaid