MEDICARE: DR. JOEL MENENDEZ PT, 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	40QA01840900	NJ

General Provider Information

NPI Number	:	1720543499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEL MENENDEZ PT, DPT

Provider Business Mailing Address
First Line	:	2025 HAMBURG TPKE STE E
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-6250
Country	:	US
Telephone Number	:	973-835-2827
Fax Number	:	976-863-1856

Provider Business Practice Location Address
First Line	:	15 CORPORATE DR STE 6
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-3120
Country	:	US
Telephone Number	:	973-368-4907
Fax Number	:

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

Provider Enumeration Date	:	02/06/2019
Last Update Date	:	05/21/2026

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