Provider Demographics
NPI:1972652857
Name:JOSEPH, MARIE CLAUDE (PA)
Entity Type:Individual
Prefix:
First Name:MARIE CLAUDE
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:506 LENOX AVE RM 3101A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1802
Mailing Address - Country:US
Mailing Address - Phone:212-939-2940
Mailing Address - Fax:212-939-2968
Practice Address - Street 1:506 MALCOLM X BLVD RM 3101A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1802
Practice Address - Country:US
Practice Address - Phone:212-939-2940
Practice Address - Fax:212-939-2968
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005918-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical