Healthcare Provider Details

I. General information

NPI: 1114276441
Provider Name (Legal Business Name): HOLSMAN PHYSICAL AND OCCUPATIONAL THERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2012
Last Update Date: 03/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SAINT GEORGES AVE SUITE 107
RAHWAY NJ
07065-2764
US

IV. Provider business mailing address

710 MILL ST UNIT H3
BELLEVILLE NJ
07109-5318
US

V. Phone/Fax

Practice location:
  • Phone: 732-428-5566
  • Fax: 732-428-5513
Mailing address:
  • Phone: 732-428-5566
  • Fax: 732-428-5513

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 Code225X00000X
TaxonomyOccupational Therapist
License Number46TR00407200
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41YS00629500
License Number StateNJ

VIII. Authorized Official

Name: DR. RICHARD S HOLSMAN
Title or Position: PRESIDENT AND CEO
Credential: PT, DPT, MAT, GCS
Phone: 973-393-5545