Provider Demographics
NPI:1851033526
Name:DR. JOSESPH H. MA
Entity Type:Organization
Organization Name:DR. JOSESPH H. MA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-762-8615
Mailing Address - Street 1:4231 COLDEN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3982
Mailing Address - Country:US
Mailing Address - Phone:718-762-8615
Mailing Address - Fax:718-762-8690
Practice Address - Street 1:4231 COLDEN ST STE 201
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3982
Practice Address - Country:US
Practice Address - Phone:718-762-8615
Practice Address - Fax:718-762-8690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01083265Medicaid