Provider Demographics
NPI:1164422564
Name:UY, JOSHUA DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:DANIEL
Last Name:UY
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 1:3615 CHESTNUT STREET
Mailing Address - Street 2:RALSTON - PENN CENTER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2612
Mailing Address - Country:US
Mailing Address - Phone:215-662-2746
Mailing Address - Fax:215-349-5648
Practice Address - Street 1:3615 CHESTNUT STREET
Practice Address - Street 2:RALSTON - PENN CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-2612
Practice Address - Country:US
Practice Address - Phone:215-662-2746
Practice Address - Fax:215-349-5648
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD424270207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1010153050003Medicaid
PA20057812OtherAMERIHEALTH MERCY
7068588OtherAETNA
PA002811OtherFIRST PRIORITY HEALTH
PA1616969OtherHIGHMARK BS
20057812OtherFIRST HEALTH
PA50059315OtherKEYSTONE CAPITAL BC
PA87127OtherGEISING
PA1010153050001Medicaid
PA101053050001Medicaid
PA50059315OtherKEYSTONE CAPITAL BC
PA083434URGMedicare PIN
PA083385Medicare PIN
PA083434WDBMedicare PIN