Basic Information
| Provider Information | |||||||||
| NPI: | 1932331873 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOSEPH | ||||||||
| FirstName: | GISELLE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | JOSEPH | ||||||||
| OtherFirstName: | GISELLE | ||||||||
| OtherMiddleName: | |||||||||
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| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3421 CONCORD RD | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174029001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178122000 | ||||||||
| FaxNumber: | 7178122010 | ||||||||
| Practice Location | |||||||||
| Address1: | 1575 BANNISTER ST | ||||||||
| Address2: | STE 1 | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174044946 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178122000 | ||||||||
| FaxNumber: | 7178122010 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2009 | ||||||||
| LastUpdateDate: | 07/15/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD441184 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207QG0300X | MD441184 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine |
ID Information
| ID | Type | State | Issuer | Description | 971233 | 01 | MD | CAREFIST MD BCBS-WMG | OTHER | P010250 | 01 | PA | GATEWAY-WMG | OTHER | 416350 | 01 | PA | UPMC-WMG | OTHER | 395283 | 01 | PA | UNISON-WMG | OTHER | 102532157 | 05 | PA | MEDICAID | 2541906 | 01 | PA | HIGHMARK BLUE SHIELD-WMG | OTHER | 30086567 | 01 | PA | AMERIHEALTH MERCY-WMG | OTHER |