Provider Demographics
NPI:1881636728
Name:WANG, JOSEPH J (DPT)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:WANG
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 1:258 S STATE ST STE 2
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-3527
Mailing Address - Country:US
Mailing Address - Phone:267-992-1338
Mailing Address - Fax:
Practice Address - Street 1:10100 JAMISON AVE STE 222
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-3832
Practice Address - Country:US
Practice Address - Phone:215-676-3870
Practice Address - Fax:215-676-6856
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007915L111N00000X
PADAPT005295225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01951415Medicaid
PAU90565Medicare UPIN
PA01951415Medicaid