Provider Demographics
NPI:1326249558
Name:JOSEF, JEFFREY M (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:M
Last Name:JOSEF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:257 LAFAYETTE AVE STE 350
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4831
Mailing Address - Country:US
Mailing Address - Phone:845-362-8500
Mailing Address - Fax:845-362-8598
Practice Address - Street 1:257 LAFAYETTE AVE STE 350
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4831
Practice Address - Country:US
Practice Address - Phone:845-362-8500
Practice Address - Fax:845-362-8598
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-28
Last Update Date:2018-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY166680207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01145853Medicaid
NY01145853Medicaid
E20476Medicare UPIN
26F601Medicare ID - Type Unspecified