Provider Demographics
NPI:1013401942
Name:NESSER, JOSEPH (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:NESSER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-4620
Mailing Address - Country:US
Mailing Address - Phone:732-822-4677
Mailing Address - Fax:
Practice Address - Street 1:251 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-4620
Practice Address - Country:US
Practice Address - Phone:732-443-0045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2020-02-27
Deactivation Date:2018-06-18
Deactivation Code:
Reactivation Date:2018-09-05
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01792800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist