Provider Demographics
NPI:1578759429
Name:JOSHUA, PHILIP (PT)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:
Last Name:JOSHUA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:PHILIP
Other - Middle Name:
Other - Last Name:JOSHUA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:198 BRIGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-5220
Mailing Address - Country:US
Mailing Address - Phone:732-272-1438
Mailing Address - Fax:732-272-1617
Practice Address - Street 1:198 BRIGHTON AVE
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-5220
Practice Address - Country:US
Practice Address - Phone:732-272-1438
Practice Address - Fax:732-272-1617
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA011455002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic