Provider Demographics
NPI:1376640177
Name:JOSEPH, MYRIAME MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:MYRIAME
Middle Name:MARIE
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIE
Other - Middle Name:MYRIAME
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1351 WASHINGTON BLVD
Mailing Address - Street 2:1ST FLOOR (DBBHC)
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2419
Mailing Address - Country:US
Mailing Address - Phone:203-621-3953
Mailing Address - Fax:203-621-3701
Practice Address - Street 1:1351 WASHINGTON BLVD
Practice Address - Street 2:1ST FLOOR (DBBHC)
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2419
Practice Address - Country:US
Practice Address - Phone:203-621-3953
Practice Address - Fax:203-621-3701
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1936462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry