Provider Demographics
NPI:1982172565
Name:PRAWER, JOSHUA M (DPT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:M
Last Name:PRAWER
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 1:960 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1644
Mailing Address - Country:US
Mailing Address - Phone:516-374-5310
Mailing Address - Fax:516-374-4450
Practice Address - Street 1:960 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1644
Practice Address - Country:US
Practice Address - Phone:516-374-5310
Practice Address - Fax:516-374-4450
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043911225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY043911OtherPHYSICAL THERAPY LICENSE