Individual
DR. JOSEPH J MINISSALE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4 GLEN COVE DR, ROCKPORT, ME 04856-4235
(207) 301-5790
Mailing address
701 OSTRUM ST STE 201, FOUNTAIN HILL, PA 18015-1152
(484) 526-6545
(484) 526-6546
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
DO2986
ME
207RG0100X
Gastroenterology Physician
Primary
OS007619L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016078690002
—
PA
Enumeration date
07/20/2005
Last updated
12/28/2021
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