Healthcare Provider Details

I. General information

NPI: 1114176062
Provider Name (Legal Business Name): JOSHUA GELFAND DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2008
Last Update Date: 12/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 VERANDA ST BUILDING 6, ROOM 3311
PORTLAND ME
04103-5545
US

IV. Provider business mailing address

73 NEWTON RD STE 101
PLAISTOW NH
03865-2424
US

V. Phone/Fax

Practice location:
  • Phone: 207-536-0702
  • Fax: 207-536-0785
Mailing address:
  • Phone: 978-388-7272
  • Fax: 978-388-7373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number18424
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: