1801991351 NPI number — DR. STEVE A JOSELOW M.D.

Table of content: DR. STEVE A JOSELOW M.D. (NPI 1801991351)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801991351 NPI number — DR. STEVE A JOSELOW M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOSELOW
Provider First Name:
STEVE
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801991351
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/16/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 ANDOVER ST
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
NORTH ANDOVER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01845-5076
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-691-5690
Provider Business Mailing Address Fax Number:
978-691-5693

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23 HAMPTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EXETER
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03833-4807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-772-4684
Provider Business Practice Location Address Fax Number:
603-772-5206
Provider Enumeration Date:
09/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  7053 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207N00000X , with the licence number: 012501 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00266192 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: P00352752 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 070002678 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: A58205 . This is a "HARVARD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 012217 . This is a "ANTHEM MAINE" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 0105727Y0NH01 . This is a "ANTHEM NEW HAMPSHIRE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 4037118 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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