Provider Demographics
NPI:1447281365
Name:KERN, JOSHUA HOWARD (MD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:HOWARD
Last Name:KERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-3516
Mailing Address - Country:US
Mailing Address - Phone:631-439-7237
Mailing Address - Fax:631-439-7292
Practice Address - Street 1:620 MAIN ST
Practice Address - Street 2:
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-3516
Practice Address - Country:US
Practice Address - Phone:631-439-7237
Practice Address - Fax:631-439-7292
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2225892085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology