Provider Demographics
NPI:1598928608
Name:JOSEPHSON, YOUSSEF (DO)
Entity Type:Individual
Prefix:DR
First Name:YOUSSEF
Middle Name:
Last Name:JOSEPHSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2271 ROUTE 33
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-1749
Mailing Address - Country:US
Mailing Address - Phone:608-890-4080
Mailing Address - Fax:609-890-4090
Practice Address - Street 1:196 GROVE AVE STE E
Practice Address - Street 2:
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08086-2139
Practice Address - Country:US
Practice Address - Phone:856-900-0041
Practice Address - Fax:856-900-0042
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08837300208100000X, 2081P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0252654Medicaid
NJ0252654Medicaid