Provider Demographics
NPI:1659731180
Name:JOSEPH, TINTO (PTA, MBA)
Entity Type:Individual
Prefix:
First Name:TINTO
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:PTA, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:452 WICKER AVE
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-7246
Mailing Address - Country:US
Mailing Address - Phone:215-900-8254
Mailing Address - Fax:
Practice Address - Street 1:452 WICKER AVE
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-7246
Practice Address - Country:US
Practice Address - Phone:215-900-8254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE010897225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant