Provider Demographics
NPI:1841618808
Name:JOSEPH, ANISE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANISE
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:672 PARKSIDE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1506
Mailing Address - Country:US
Mailing Address - Phone:718-246-5700
Mailing Address - Fax:718-246-5750
Practice Address - Street 1:672 PARKSIDE AVE FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-1506
Practice Address - Country:US
Practice Address - Phone:718-246-5700
Practice Address - Fax:718-246-5750
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-06
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274438208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics