MEDICARE: RITA ELSY JOSEPH DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	028977-1	NY

General Provider Information

NPI Number	:	1528118353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RITA ELSY JOSEPH DPT

Provider Business Mailing Address
First Line	:	8823 215TH ST
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11427-2403
Country	:	US
Telephone Number	:	718-776-3880
Fax Number	:

Provider Business Practice Location Address
First Line	:	1450 MADISON AVE
Second Line	:	BOX 1674
City	:	NEW YORK
State	:	NY
Zip	:	10029-6508
Country	:	US
Telephone Number	:	212-241-7172
Fax Number	:	212-426-5369

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	07/08/2007

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