Provider Demographics
NPI:1508302928
Name:JOSEPH, ALAN (DPT)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 HUDSON ST
Mailing Address - Street 2:3
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5810
Mailing Address - Country:US
Mailing Address - Phone:609-240-5905
Mailing Address - Fax:
Practice Address - Street 1:1556 3RD AVE
Practice Address - Street 2:211
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3100
Practice Address - Country:US
Practice Address - Phone:609-240-5905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041244225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist