Provider Demographics
NPI:1306982392
Name:ROSS, JOEL S (MD)
Entity type:Individual
Prefix:MR
First Name:JOEL
Middle Name:S
Last Name:ROSS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4 INDUSTRIAL WAY W
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-4238
Mailing Address - Country:US
Mailing Address - Phone:732-263-0101
Mailing Address - Fax:732-263-0024
Practice Address - Street 1:80 PAVILION AVENUE
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740
Practice Address - Country:US
Practice Address - Phone:732-571-1535
Practice Address - Fax:732-571-5115
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2014-03-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA47821207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0904503Medicaid
511112Medicare PIN
D06756Medicare UPIN