Healthcare Provider Details

I. General information

NPI: 1477846442
Provider Name (Legal Business Name): JOSHUA GELLERT DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2011
Last Update Date: 10/24/2023
Certification Date: 10/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 MONTLAKE BLVD
SEATTLE WA
98195-0007
US

IV. Provider business mailing address

4720 CENTER BLVD APT 1202
LONG ISLAND CITY NY
11109-5684
US

V. Phone/Fax

Practice location:
  • Phone: 206-520-5000
  • Fax:
Mailing address:
  • Phone: 212-434-4623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number03330-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: