Provider Demographics
NPI:1548235278
Name:CHASON, JOSHUA CLIFFORD (ATC, CSCS)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:CLIFFORD
Last Name:CHASON
Suffix:
Gender:M
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PAWLING
Mailing Address - State:NY
Mailing Address - Zip Code:12564-1318
Mailing Address - Country:US
Mailing Address - Phone:845-855-4752
Mailing Address - Fax:
Practice Address - Street 1:ANNANDALE RD
Practice Address - Street 2:STEVENSON GYMNASIUM
Practice Address - City:RED HOOK
Practice Address - State:NY
Practice Address - Zip Code:12504
Practice Address - Country:US
Practice Address - Phone:845-758-7694
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233183146N00000X
NY001160-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer