Provider Demographics
NPI:1477590396
Name:DORSTEN, JOSEPH F (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:F
Last Name:DORSTEN
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Gender:M
Credentials:DO
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Mailing Address - Street 1:183 PINEHURST AVE
Mailing Address - Street 2:APT 52
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-1824
Mailing Address - Country:US
Mailing Address - Phone:646-509-7410
Mailing Address - Fax:718-748-2266
Practice Address - Street 1:666 GREENWICH ST
Practice Address - Street 2:APT 843
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-6329
Practice Address - Country:US
Practice Address - Phone:646-509-7410
Practice Address - Fax:718-748-2266
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2016-09-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1998352085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01640284Medicaid
NY10487511OtherCAQH