Provider Demographics
NPI:1851351571
Name:ADDEO, JOSEPH N (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:N
Last Name:ADDEO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:474 OVINGTON AVE
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1550
Mailing Address - Country:US
Mailing Address - Phone:718-238-2625
Mailing Address - Fax:718-238-2704
Practice Address - Street 1:474 OVINGTON AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1550
Practice Address - Country:US
Practice Address - Phone:718-238-2625
Practice Address - Fax:718-238-2704
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY194877207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G34493Medicare UPIN
NY460331Medicare ID - Type Unspecified