Provider Demographics
NPI:1659160307
Name:MARKESEINES, JOSEPH GERARD (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:GERARD
Last Name:MARKESEINES
Suffix:
Gender:M
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 726
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-0726
Mailing Address - Country:US
Mailing Address - Phone:774-420-2642
Mailing Address - Fax:774-420-2616
Practice Address - Street 1:85 PRESCOTT ST STE 302
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2610
Practice Address - Country:US
Practice Address - Phone:774-420-2611
Practice Address - Fax:774-420-2616
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-30
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2334156363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110222656AMedicaid