Provider Demographics
NPI:1699027953
Name:HOLSMAN PT REHABILITATION
Entity Type:Organization
Organization Name:HOLSMAN PT REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT DPT 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:973-759-1494
Mailing Address - Fax:973-759-0557
Practice Address - Street 1:711 KEARNY AVE
Practice Address - Street 2:2ND FLR
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-3003
Practice Address - Country:US
Practice Address - Phone:201-535-8555
Practice Address - Fax:201-299-3506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-11
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA009789002251G0304X
NJ46TR00505400225X00000X
NJ41YS00629500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty