Provider Demographics
NPI:1780990978
Name:LURIE, JOSHUA (DPT)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:
Last Name:LURIE
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 1:17071 VENTURA BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-4130
Mailing Address - Country:US
Mailing Address - Phone:818-232-4884
Mailing Address - Fax:
Practice Address - Street 1:17071 VENTURA BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-4130
Practice Address - Country:US
Practice Address - Phone:818-232-4884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2012-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEP345YOtherMEDICARE PTAN