Provider Demographics
NPI:1366612863
Name:CHAVEZ CAREY, JOSEPH CHARLES
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:CHARLES
Last Name:CHAVEZ CAREY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 STATE ROUTE 17M
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-4169
Mailing Address - Country:US
Mailing Address - Phone:845-333-7830
Mailing Address - Fax:845-333-7475
Practice Address - Street 1:475 STATE ROUTE 17M
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-4169
Practice Address - Country:US
Practice Address - Phone:845-333-7830
Practice Address - Fax:845-333-7475
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA100867207Q00000X
NY281223207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine