Provider Demographics
NPI:1710900865
Name:JOSHI, AMI S (DO)
Entity Type:Individual
Prefix:
First Name:AMI
Middle Name:S
Last Name:JOSHI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 SPRUCE STREET
Mailing Address - Street 2:STE. 304
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106
Mailing Address - Country:US
Mailing Address - Phone:215-829-3521
Mailing Address - Fax:215-829-3532
Practice Address - Street 1:700 SPRUCE STREET
Practice Address - Street 2:STE. 304
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106
Practice Address - Country:US
Practice Address - Phone:215-829-3521
Practice Address - Fax:215-829-3532
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB080750207R00000X
PAOS012672207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA037276OtherMLHC MEDICARE AA #
1881376OtherPENNSYVANIA BLUE SHIELD
60025154OtherHORIZON NJ HEALTH
2289890OtherCIGNA
2750962OtherUNITED HEALTH CARE
P3701752OtherOXFORD HEALTH PLAN
01077795200OtherAMERICHOICE
2742606000OtherAMERIHEALTH, HMO, KEYSTONE, IBC
42726OtherUNIVERSITY HEALTH PLAN
NJ0114138Medicaid
1326805OtherAETNA US-HEALTHCARE
P00359748OtherRAIL ROAD MEDICARE
3K6227OtherHEALTHNET
PA824305OtherMLHC B/S AA #
60025154OtherHORIZON NJ HEALTH
PA23-2359401OtherMLHC TIN