Healthcare Provider Details
I. General information
NPI: 1033540521
Provider Name (Legal Business Name): HOLSMAN ORTHOPEDIC AND SPORTS PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/09/2013
Last Update Date: 12/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1700 RT 3 WEST
CLIFTON NJ
07013-3928
US
IV. Provider business mailing address
710 MILL ST UNIT H3
BELLEVILLE NJ
07109-5318
US
V. Phone/Fax
- Phone: 862-591-1000
- Fax: 862-591-1005
- Phone: 862-591-1000
- Fax: 862-591-1005
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | NJ |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | NJ |
VIII. Authorized Official
Name: DR.
RICHARD
S
HOLSMAN
Title or Position: PRESIDENT AND CEO
Credential: PT, DPT, MAT, GCS
Phone: 973-759-1494