Provider Demographics
NPI:1588811210
Name:DISCIENZA, JOSEPH (MPT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:DISCIENZA
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 N BLACK HORSE PIKE
Mailing Address - Street 2:SUITE # 5
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094-2840
Mailing Address - Country:US
Mailing Address - Phone:856-728-4100
Mailing Address - Fax:856-728-4415
Practice Address - Street 1:1035 N BLACK HORSE PIKE
Practice Address - Street 2:SUITE # 5
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08094-2840
Practice Address - Country:US
Practice Address - Phone:856-728-4100
Practice Address - Fax:856-728-4415
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00815300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist