Provider Demographics
NPI:1386814572
Name:JOSEPH, SUSAN M (PA)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:M
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:3050 ORCHARD PARK RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-4658
Mailing Address - Country:US
Mailing Address - Phone:716-675-5222
Mailing Address - Fax:716-675-9329
Practice Address - Street 1:3050 ORCHARD PARK RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-4658
Practice Address - Country:US
Practice Address - Phone:716-675-5222
Practice Address - Fax:716-675-9329
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY012413-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
005304444001OtherBLUE CROSS
NY03055158Medicaid
P00773791OtherRAILROAD MEDICARE
9515172OtherINDEPENDENT HEALTH
00028442001OtherUNIVERA
P00773791OtherRAILROAD MEDICARE