Provider Demographics
NPI:1720318769
Name:JOSHUA, SUMA (PA)
Entity Type:Individual
Prefix:MS
First Name:SUMA
Middle Name:
Last Name:JOSHUA
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Gender:F
Credentials:PA
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Mailing Address - Street 1:107 W 4TH ST
Mailing Address - Street 2:ADMINISTRATION
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-4002
Mailing Address - Country:US
Mailing Address - Phone:914-699-7200
Mailing Address - Fax:914-699-0837
Practice Address - Street 1:9 UNION AVE
Practice Address - Street 2:WILLIAMS SCHOOL BASED HEALTH CENTER
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-3510
Practice Address - Country:US
Practice Address - Phone:914-699-7200
Practice Address - Fax:914-699-0837
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2014-09-17
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Provider Licenses
StateLicense IDTaxonomies
NY012679363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant