Provider Demographics
NPI:1184948176
Name:JOASIL, OSMAN D (DPM)
Entity type:Individual
Prefix:DR
First Name:OSMAN
Middle Name:D
Last Name:JOASIL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4025 CARPENTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-3601
Mailing Address - Country:US
Mailing Address - Phone:646-796-5596
Mailing Address - Fax:
Practice Address - Street 1:4334A WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-3098
Practice Address - Country:US
Practice Address - Phone:800-804-1330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000779213E00000X
NYN005973213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02569097Medicaid
NY02569097Medicaid
NYA300068058Medicare PIN
NYPJ1281Medicare PIN