Provider Demographics
NPI:1760939672
Name:NOBBE, JOANNA ADDINE (DPT)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:ADDINE
Last Name:NOBBE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3534 RIVERDALE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1804
Mailing Address - Country:US
Mailing Address - Phone:347-692-8185
Mailing Address - Fax:347-284-1830
Practice Address - Street 1:3534 RIVERDALE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1804
Practice Address - Country:US
Practice Address - Phone:347-692-8185
Practice Address - Fax:347-284-1830
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040694225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist