Provider Demographics
NPI:1720156615
Name:JOSEPH, CYRIL (MD)
Entity Type:Individual
Prefix:
First Name:CYRIL
Middle Name:
Last Name:JOSEPH
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 1:175 CAREW ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-2391
Mailing Address - Country:US
Mailing Address - Phone:413-732-8254
Mailing Address - Fax:413-747-5870
Practice Address - Street 1:175 CAREW ST STE 200
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2391
Practice Address - Country:US
Practice Address - Phone:413-734-8254
Practice Address - Fax:413-747-5870
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA250257207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H08046Medicare UPIN