Healthcare Provider Details

I. General information

NPI: 1386253953
Provider Name (Legal Business Name): HOLSMAN PHYSICAL THERAPY AND WELLNESS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2020
Last Update Date: 08/24/2021
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

724 RIDGE RD
LYNDHURST NJ
07071-3216
US

IV. Provider business mailing address

710 MILL ST UNIT H3
BELLEVILLE NJ
07109-5306
US

V. Phone/Fax

Practice location:
  • Phone: 201-500-9812
  • Fax: 949-655-8540
Mailing address:
  • Phone: 973-759-1494
  • Fax: 973-759-0557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: RICHARD S. HOLSMAN
Title or Position: PRESIDENT
Credential: DPT
Phone: 973-393-5545