Provider Demographics
NPI:1609180330
Name:JOSEPH, EUNIDE (FNP)
Entity Type:Individual
Prefix:
First Name:EUNIDE
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 WILBUR RD
Mailing Address - Street 2:
Mailing Address - City:THIELLS
Mailing Address - State:NY
Mailing Address - Zip Code:10984-7555
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 WILBUR RD
Practice Address - Street 2:
Practice Address - City:THIELLS
Practice Address - State:NY
Practice Address - Zip Code:10984-7555
Practice Address - Country:US
Practice Address - Phone:845-947-6202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF335704-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily