Provider Demographics
NPI:1457397606
Name:HERRERA, JOSEPH E (DO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:E
Last Name:HERRERA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:BOX 1240B
Mailing Address - Street 2:5 E. 98TH STREET 6TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-241-9469
Mailing Address - Fax:212-369-6389
Practice Address - Street 1:BOX 1240B
Practice Address - Street 2:5 E. 98TH STREET 6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-9469
Practice Address - Fax:212-369-6389
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY222712-1225400000X
NY2227122081S0010X, 208VP0014X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02677067Medicaid
NY1241J1Medicare ID - Type Unspecified
NY02677067Medicaid