Provider Demographics
NPI:1629350467
Name:HOLSMAN PHYSICAL THERAPY AND REHABILITATION PC
Entity Type:Organization
Organization Name:HOLSMAN PHYSICAL THERAPY AND REHABILITATION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, MAT, GCS
Authorized Official - Phone:973-393-5545
Mailing Address - Street 1:710 MILL ST
Mailing Address - Street 2:UNIT H3
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-5318
Mailing Address - Country:US
Mailing Address - Phone:973-393-5545
Mailing Address - Fax:973-759-0557
Practice Address - Street 1:1070 CLIFTON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3619
Practice Address - Country:US
Practice Address - Phone:973-246-6565
Practice Address - Fax:973-883-0140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-19
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00978900225100000X, 2251G0304X
NJ40QA01340100225100000X
NJ46TR00485600225X00000X
NJ46TR00214900225X00000X
NJ41YS00629500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty