Provider Demographics
NPI:1194976068
Name:MOISE JOSEPH, MD, INC
Entity type:Organization
Organization Name:MOISE JOSEPH, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MOISE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-321-1437
Mailing Address - Street 1:10928 W LAWRENCE LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-2940
Mailing Address - Country:US
Mailing Address - Phone:623-374-4447
Mailing Address - Fax:623-374-4447
Practice Address - Street 1:5338 N RATTLER CT
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-4164
Practice Address - Country:US
Practice Address - Phone:602-321-1437
Practice Address - Fax:623-215-7205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ33517323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility