Provider Demographics
NPI:1598456923
Name:LOVE, JOSEPH S (PA STUDENT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:S
Last Name:LOVE
Suffix:
Gender:M
Credentials:PA STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 W SHADY LN
Mailing Address - Street 2:
Mailing Address - City:ENOLA
Mailing Address - State:PA
Mailing Address - Zip Code:17025-2241
Mailing Address - Country:US
Mailing Address - Phone:717-440-0864
Mailing Address - Fax:
Practice Address - Street 1:8901 ROCKVILLE PIKE
Practice Address - Street 2:BETHESDA
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:20899
Practice Address - Country:US
Practice Address - Phone:412-852-0731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider