Provider Demographics
NPI:1518627306
Name:JOSHUA SISSER, MD, P.C.
Entity Type:Organization
Organization Name:JOSHUA SISSER, MD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:SISSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-222-5999
Mailing Address - Street 1:7103 170TH ST
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-3333
Mailing Address - Country:US
Mailing Address - Phone:718-222-5999
Mailing Address - Fax:718-387-6429
Practice Address - Street 1:775 PARK AVE STE 225
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-7532
Practice Address - Country:US
Practice Address - Phone:718-222-5999
Practice Address - Fax:718-387-6429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty