Individual
DR. MIRIAM DINAH JOSEPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
19 WEST 34TH ST, PENTHOUSE, NY, NY 10001
(917) 701-6739
Mailing address
19 W 34TH ST, PENTHOUSE, NEW YORK, NY 10001-3006
(917) 701-6739
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
020309
NY
103TC0700X
Clinical Psychologist
020309
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
MEDICARE
NY
01
—
S20309-1
WORKER'S COMPENSATION
NY
Enumeration date
06/16/2015
Last updated
06/29/2016
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