Provider Demographics
NPI:1467542456
Name:NAZZARI, JOSEPH THOMAS
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:THOMAS
Last Name:NAZZARI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 EAGLE ROCK AVE 2ND
Mailing Address - Street 2:
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-3167
Mailing Address - Country:US
Mailing Address - Phone:973-887-9000
Mailing Address - Fax:973-887-3816
Practice Address - Street 1:11 EAGLE ROCK AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-3101
Practice Address - Country:US
Practice Address - Phone:973-887-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA06098225100000X
NY016862-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJNL7012OtherHEALTHNET
NJ1163433OtherUNITED HEALTHCARE
NJP811353OtherOXFORD NJ
NYQ2875ZT6W1Medicare PIN
NJ650017139Medicare PIN
NJ023961Medicare PIN
NJNL7012OtherHEALTHNET
NJ1163433OtherUNITED HEALTHCARE
NYQ28751Medicare PIN