Provider Demographics
NPI:1689752032
Name:MA, JOSEPH H (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:H
Last Name:MA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4231 COLDEN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355
Mailing Address - Country:US
Mailing Address - Phone:718-762-8615
Mailing Address - Fax:718-762-8690
Practice Address - Street 1:4231 COLDEN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-762-8615
Practice Address - Fax:718-762-8690
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY170986207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01083265Medicaid
NY02620Medicare ID - Type UnspecifiedGHI
A61444Medicare UPIN