Provider Demographics
NPI:1942489000
Name:OSIPOW, JOSEPH DAVID (DDS)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DAVID
Last Name:OSIPOW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:842 PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-1847
Mailing Address - Country:US
Mailing Address - Phone:212-570-6062
Mailing Address - Fax:212-737-0696
Practice Address - Street 1:842 PARK AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-1847
Practice Address - Country:US
Practice Address - Phone:212-570-6062
Practice Address - Fax:212-737-0696
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0246011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice