Provider Demographics
NPI:1285767954
Name:JOSEPH, RAYMOND G (DC)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:G
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GAIL DR
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3605
Mailing Address - Country:US
Mailing Address - Phone:845-634-0017
Mailing Address - Fax:845-634-0867
Practice Address - Street 1:5 GAIL DR
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3605
Practice Address - Country:US
Practice Address - Phone:845-634-0017
Practice Address - Fax:845-634-0867
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX3919111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY606498OtherACN
NYX36671Medicare ID - Type UnspecifiedMEDICARE
NY606498OtherACN