Provider Demographics
NPI:1821281254
Name:NORMAN, JOEL EDWARD (DPT)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:EDWARD
Last Name:NORMAN
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 1:244 GLEN COVE AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-4171
Mailing Address - Country:US
Mailing Address - Phone:516-801-6650
Mailing Address - Fax:516-801-6653
Practice Address - Street 1:244 GLEN COVE AVE
Practice Address - Street 2:SUITE D
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-4171
Practice Address - Country:US
Practice Address - Phone:516-801-6650
Practice Address - Fax:516-801-6653
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029593225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist