Provider Demographics
NPI:1295707461
Name:FOGELMAN, JOSHUA P (MD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:P
Last Name:FOGELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 DUTCH HILL RD
Mailing Address - Street 2:SUITE 18
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962-1723
Mailing Address - Country:US
Mailing Address - Phone:845-359-4770
Mailing Address - Fax:845-359-0017
Practice Address - Street 1:60 DUTCH HILL RD
Practice Address - Street 2:SUITE 18
Practice Address - City:ORANGEBURG
Practice Address - State:NY
Practice Address - Zip Code:10962-1723
Practice Address - Country:US
Practice Address - Phone:845-359-4770
Practice Address - Fax:845-359-0017
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212903174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000057863OtherGHI HMO
2108577OtherUNITED HEALTHCARE
311021OtherWELLCARE
P2485132OtherOXFORD
1729248OtherCIGNA
2K5851OtherEMPIRE BLUECROSS BLUESHIELD
4C3363OtherHEALTHNET
7409259OtherAETNA
NY02337346Medicaid
070017424OtherRAILROAD MEDICARE
17273OtherHUDSON HEALTHPLANS
2299624OtherGHI
000000057863OtherGHI HMO
NY02337346Medicaid