Provider Demographics
NPI:1770711541
Name:NASH, JOSEPH KENYON (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:KENYON
Last Name:NASH
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 E 71ST ST, 5TH FLOOR
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4839
Mailing Address - Country:US
Mailing Address - Phone:212-606-1250
Mailing Address - Fax:
Practice Address - Street 1:525 E 71ST ST, 5TH FLOOR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4839
Practice Address - Country:US
Practice Address - Phone:212-606-1250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012240363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant