Provider Demographics
NPI:1376922336
Name:WESTLAKE, JOSEPH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:WESTLAKE
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 1:430 MARVIN AVE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1130
Mailing Address - Country:US
Mailing Address - Phone:201-916-6746
Mailing Address - Fax:
Practice Address - Street 1:430 MARVIN AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1130
Practice Address - Country:US
Practice Address - Phone:201-916-6746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-23
Last Update Date:2015-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist