Provider Demographics
NPI:1790879138
Name:RAYMOND JOSEPH MD
Entity Type:Organization
Organization Name:RAYMOND JOSEPH MD
Other - Org Name:COMUNITY HEALTH CENTER NEPA
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:J
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-825-0770
Mailing Address - Street 1:165 CAREY AVE
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-2112
Mailing Address - Country:US
Mailing Address - Phone:570-825-0770
Mailing Address - Fax:570-825-0922
Practice Address - Street 1:165 CAREY AVE
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-2112
Practice Address - Country:US
Practice Address - Phone:570-825-0770
Practice Address - Fax:570-825-0922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021137E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA026148OtherFIRST PRIORITY HEALTH
PA026148OtherFIRST PRIORITY HEALTH