Provider Demographics
NPI:1134192446
Name:JOSEPH, LIJA (MD)
Entity type:Individual
Prefix:DR
First Name:LIJA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 VARNUM AVE
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-2193
Mailing Address - Country:US
Mailing Address - Phone:978-937-6341
Mailing Address - Fax:978-937-6085
Practice Address - Street 1:295 VARNUM AVE
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-2193
Practice Address - Country:US
Practice Address - Phone:978-937-6341
Practice Address - Fax:978-937-6085
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA220563207ZP0102X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30204627Medicaid
MA2044421Medicaid
MAA37487Medicare ID - Type Unspecified
NH30204627Medicaid