Provider Demographics
NPI:1003317496
Name:RAYMOND J JOSEPH MD LLC
Entity type:Organization
Organization Name:RAYMOND J JOSEPH MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-825-0770
Mailing Address - Street 1:165 CAREY AVE
Mailing Address - Street 2:
Mailing Address - City:WILKES -BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702
Mailing Address - Country:US
Mailing Address - Phone:570-825-0770
Mailing Address - Fax:570-825-0922
Practice Address - Street 1:165 CAREY AVE
Practice Address - Street 2:
Practice Address - City:WILKES -BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702
Practice Address - Country:US
Practice Address - Phone:570-825-0770
Practice Address - Fax:570-825-0922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021137E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty