Provider Demographics
NPI:1811933088
Name:BRILL, JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:BRILL
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 1:970 NORTH BROADWAY SUITE 209
Mailing Address - Street 2:ATTN: PDGOW
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1311
Mailing Address - Country:US
Mailing Address - Phone:914-965-3366
Mailing Address - Fax:914-965-1310
Practice Address - Street 1:102 PARK AVENUE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703
Practice Address - Country:US
Practice Address - Phone:914-968-1611
Practice Address - Fax:914-968-7395
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY156006207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF03305Medicare UPIN
NY36L231Medicare ID - Type Unspecified