Provider Demographics
NPI:1790908648
Name:JOSUE, STANLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:
Last Name:JOSUE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:56-45 MAIN STREET, 5 SOUTH 501 DEPARTMENT OF MEDICINE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-2212
Mailing Address - Country:US
Mailing Address - Phone:718-670-7137
Mailing Address - Fax:917-590-0832
Practice Address - Street 1:56-45 MAIN STREET, 5 SOUTH 501 DEPARTMENT OF MEDICINE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-1135
Practice Address - Country:US
Practice Address - Phone:718-670-7137
Practice Address - Fax:610-595-6731
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY242851207R00000X
PAMD431717208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine