Healthcare Provider Details

I. General information

NPI: 1659079069
Provider Name (Legal Business Name): HOLSMAN PHYSICAL AND OCCUPATIONAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 02/16/2023
Certification Date: 02/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SAINT GEORGES AVE STE 107
RAHWAY NJ
07065-2713
US

IV. Provider business mailing address

710 MILL ST UNIT H3
BELLEVILLE NJ
07109-5306
US

V. Phone/Fax

Practice location:
  • Phone: 732-428-5566
  • Fax:
Mailing address:
  • Phone: 973-393-5545
  • 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 HOLSMAN
Title or Position: PRESIDENT
Credential: PT, DPT, GCS
Phone: 973-393-5545