Healthcare Provider Details

I. General information

NPI: 1134770431
Provider Name (Legal Business Name): HOLSMAN PHYSICAL THERAPY AND WELLNESS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2019
Last Update Date: 09/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 N 5TH ST STE C-104
NEWARK NJ
07107-4804
US

IV. Provider business mailing address

710 MILL ST UNIT H3
BELLEVILLE NJ
07109-5306
US

V. Phone/Fax

Practice location:
  • Phone: 973-910-2300
  • Fax: 973-910-2300
Mailing address:
  • Phone: 973-759-1494
  • Fax: 973-759-0557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: RICHARD HOLSMAN
Title or Position: PRESIDENT
Credential: PT, DPT, GCS
Phone: 973-393-5545