Provider Demographics
NPI:1689263402
Name:WASSERMAN, JOSHUA (DPT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:WASSERMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 E 18TH ST APT 7W
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2441
Mailing Address - Country:US
Mailing Address - Phone:646-286-1022
Mailing Address - Fax:
Practice Address - Street 1:180 SYLVAN AVE STE 4
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2519
Practice Address - Country:US
Practice Address - Phone:718-650-6230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty