Provider Demographics
NPI:1851886709
Name:MENDOZA, JOSEPH BRIAN TIU (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH BRIAN
Middle Name:TIU
Last Name:MENDOZA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 CUSTER AVE
Mailing Address - Street 2:APT 116
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-1750
Mailing Address - Country:US
Mailing Address - Phone:551-253-7458
Mailing Address - Fax:
Practice Address - Street 1:1036 STUYVESANT AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-6023
Practice Address - Country:US
Practice Address - Phone:908-851-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-23
Last Update Date:2019-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01794200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist