Provider Demographics
NPI:1508903014
Name:CHRISTENSEN, JOSEPH W (OTRL)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:W
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 719
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08510-0719
Mailing Address - Country:US
Mailing Address - Phone:917-703-0781
Mailing Address - Fax:732-928-4181
Practice Address - Street 1:627 WINTERBERRY BLVD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-5343
Practice Address - Country:US
Practice Address - Phone:917-703-0781
Practice Address - Fax:732-928-4181
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011475-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics