Provider Demographics
NPI:1750489712
Name:NUSBAUM, JOSEPH W (DC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:W
Last Name:NUSBAUM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 PINE ST
Mailing Address - Street 2:
Mailing Address - City:WEST HURLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12491-5506
Mailing Address - Country:US
Mailing Address - Phone:845-231-4109
Mailing Address - Fax:
Practice Address - Street 1:73 PINE ST
Practice Address - Street 2:
Practice Address - City:WEST HURLEY
Practice Address - State:NY
Practice Address - Zip Code:12491-5506
Practice Address - Country:US
Practice Address - Phone:845-231-4109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010921-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor