Healthcare Provider Details

I. General information

NPI: 1164648481
Provider Name (Legal Business Name): RICHARD S. HOLSMAN PT, DPT, GCS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 09/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 MILL ST UNIT H3
BELLEVILLE NJ
07109-5318
US

IV. Provider business mailing address

710 MILL ST. UNIT H3
BELLEVILLE NJ
07109-5306
US

V. Phone/Fax

Practice location:
  • Phone: 973-759-1494
  • Fax: 973-759-0557
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number40QA00978900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number019510
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: