Healthcare Provider Details

I. General information

NPI: 1295369346
Provider Name (Legal Business Name): ALEXANDER CHARLES GEISSBUHLER PT, DPT, OCS, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2020
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

348 EVELYN ST
PARAMUS NJ
07652-2908
US

IV. Provider business mailing address

348 EVELYN ST
PARAMUS NJ
07652-2908
US

V. Phone/Fax

Practice location:
  • Phone: 201-693-2901
  • Fax:
Mailing address:
  • Phone: 201-693-2901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number40QA01933900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number40QA01933900
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number045560
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number045560
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: