Provider Demographics
NPI:1427283944
Name:JOSEPH, MYRIAM (NP)
Entity type:Individual
Prefix:
First Name:MYRIAM
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 STERLING PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-3903
Mailing Address - Country:US
Mailing Address - Phone:718-613-1700
Mailing Address - Fax:718-363-1050
Practice Address - Street 1:803 STERLING PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-3903
Practice Address - Country:US
Practice Address - Phone:718-613-1700
Practice Address - Fax:718-363-1050
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY579102-1163W00000X
NYF304982-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse