Provider Demographics
NPI:1083676589
Name:ADELMAN, WILLIAM JAY (PT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JAY
Last Name:ADELMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6261 N CALLE RETRETA SERENA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-0949
Mailing Address - Country:US
Mailing Address - Phone:520-885-9400
Mailing Address - Fax:
Practice Address - Street 1:5155 E FARNESS DR
Practice Address - Street 2:STE 111B
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2158
Practice Address - Country:US
Practice Address - Phone:520-327-5959
Practice Address - Fax:520-327-5950
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0461225100000X
NY003284225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0088550OtherBLUE CROSS
86-0487479OtherFEDERAL TAX ID NUMBER
86-0487479OtherFEDERAL TAX ID NUMBER