Provider Demographics
NPI:1265839443
Name:KISH, JOSEF PETER
Entity Type:Individual
Prefix:
First Name:JOSEF PETER
Middle Name:
Last Name:KISH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100A HAVERHILL ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-4251
Mailing Address - Country:US
Mailing Address - Phone:978-682-5276
Mailing Address - Fax:978-688-4932
Practice Address - Street 1:100A HAVERHILL STREET
Practice Address - Street 2:
Practice Address - City:METHEUN
Practice Address - State:MA
Practice Address - Zip Code:01844
Practice Address - Country:US
Practice Address - Phone:978-682-5276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health