Provider Demographics
NPI:1134814684
Name:MADERA, JOSHUA DANIEL
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:DANIEL
Last Name:MADERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 LIVINGSTON ST UNIT H
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-6806
Mailing Address - Country:US
Mailing Address - Phone:610-554-3656
Mailing Address - Fax:
Practice Address - Street 1:1200 S. CEDAR CREST BLVD
Practice Address - Street 2:JAINDL 6TH FLOOR
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103
Practice Address - Country:US
Practice Address - Phone:610-402-7712
Practice Address - Fax:484-224-1306
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program