Basic Information
Provider Information
NPI: 1902865314
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JOSEF
FirstName: ERNEST
MiddleName: MICHAEL
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1830 GOOD HOPE RD STE 2F
Address2:  
City: ENOLA
State: PA
PostalCode: 170251233
CountryCode: US
TelephoneNumber: 7177328877
FaxNumber: 7177329241
Practice Location
Address1: 1824 GOOD HOPE ROAD
Address2:  
City: ENOLA
State: PA
PostalCode: 170251233
CountryCode: US
TelephoneNumber: 7177328877
FaxNumber: 7177329241
Other Information
ProviderEnumerationDate: 03/23/2006
LastUpdateDate: 02/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XMD042694LPAY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
00129430705PA MEDICAID


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