Provider Demographics
NPI:1225682545
Name:JOSEPH, LOLITHA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:LOLITHA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 PARLIAMENT DR
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-6937
Mailing Address - Country:US
Mailing Address - Phone:845-708-8899
Mailing Address - Fax:
Practice Address - Street 1:77 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-3140
Practice Address - Country:US
Practice Address - Phone:914-472-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF343647207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine