Provider Demographics
NPI:1578173399
Name:DWY, JOSEPH
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:DWY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 COLLINS ST
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:12529-5911
Mailing Address - Country:US
Mailing Address - Phone:518-325-4943
Mailing Address - Fax:
Practice Address - Street 1:STRATTON DR
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-1304
Practice Address - Country:US
Practice Address - Phone:607-753-4602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer