Basic Information
| Provider Information | |||||||||
| NPI: | 1316451644 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOSE | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MA | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 671 HOES LN W | ||||||||
| Address2: | |||||||||
| City: | PISCATAWAY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088548021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322355000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4326 US HIGHWAY 1 | ||||||||
| Address2: | |||||||||
| City: | MONMOUTH JUNCTION | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088521906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322355910 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2017 | ||||||||
| LastUpdateDate: | 11/22/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | NJ | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.