Provider Demographics
NPI:1992202030
Name:BOXER, JOSEPH CHARLES (CRPA)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:CHARLES
Last Name:BOXER
Suffix:
Gender:M
Credentials:CRPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SICKLES AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-4030
Mailing Address - Country:US
Mailing Address - Phone:914-613-0700
Mailing Address - Fax:914-355-5425
Practice Address - Street 1:20 SICKLES AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-4030
Practice Address - Country:US
Practice Address - Phone:914-613-0700
Practice Address - Fax:914-355-5425
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYP100047175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist