Provider Demographics
NPI:1508205055
Name:JOSEPH, SHIJA (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:SHIJA
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 1:55 BEAUMONT CIR
Mailing Address - Street 2:APT 2
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-1535
Mailing Address - Country:US
Mailing Address - Phone:914-602-2303
Mailing Address - Fax:
Practice Address - Street 1:77 PONDFIELD RD
Practice Address - Street 2:FLOOR 2
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-3809
Practice Address - Country:US
Practice Address - Phone:914-771-9286
Practice Address - Fax:914-771-5182
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337827363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily