Provider Demographics
NPI:1316141526
Name:HOLMGREN, JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:HOLMGREN
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 1:338 E 30TH ST
Mailing Address - Street 2:SUITE 2RE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8318
Mailing Address - Country:US
Mailing Address - Phone:917-338-6484
Mailing Address - Fax:
Practice Address - Street 1:338 E 30TH ST
Practice Address - Street 2:SUITE 2RE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8318
Practice Address - Country:US
Practice Address - Phone:917-338-6484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2277232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry