Provider Demographics
NPI:1205892023
Name:ALLISON, JOSEPH C (PT)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:C
Last Name:ALLISON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13A MAIN ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-1941
Mailing Address - Country:US
Mailing Address - Phone:973-726-7400
Mailing Address - Fax:973-726-7440
Practice Address - Street 1:13A MAIN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1941
Practice Address - Country:US
Practice Address - Phone:973-726-7400
Practice Address - Fax:973-726-7440
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00732300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ40QA00732300Medicare Oscar/Certification