Provider Demographics
NPI:1699438614
Name:JOSEPH, ERICKA MARIE
Entity type:Individual
Prefix:
First Name:ERICKA
Middle Name:MARIE
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 NEWTON AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-4255
Mailing Address - Country:US
Mailing Address - Phone:937-397-5471
Mailing Address - Fax:
Practice Address - Street 1:1440 NEWTON AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-4255
Practice Address - Country:US
Practice Address - Phone:937-397-5471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-17
Last Update Date:2021-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health