Provider Demographics
NPI:1205025541
Name:KUSHMAN, JOSEPH (DC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:KUSHMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 COLONIAL AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-9022
Mailing Address - Country:US
Mailing Address - Phone:908-688-0898
Mailing Address - Fax:908-688-3274
Practice Address - Street 1:224 COLONIAL AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-9022
Practice Address - Country:US
Practice Address - Phone:908-688-0898
Practice Address - Fax:908-688-3274
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00562100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ38MC00562100OtherSTATE LIC
NJ094526ULYMedicare PIN