Individual
JOAN MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-2500
Mailing address
622 W 168TH ST, NEW YORK, NY 10032-3720
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
298232
NY
207P00000X
Emergency Medicine Physician
61345
CT
207R00000X
Internal Medicine Physician
61345
CT
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
61345
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/19/2015
Last updated
08/07/2019
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