MEDICARE: MR. SANJEEV JOSEPH MSPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	029555	NY

General Provider Information

NPI Number	:	1518152081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SANJEEV JOSEPH MSPT

Provider Business Mailing Address
First Line	:	5860 RANCH LAKE BLVD
Second Line	:	SUITE A
City	:	BRADENTON
State	:	FL
Zip	:	34202-3708
Country	:	US
Telephone Number	:	941-417-8300
Fax Number	:	941-417-8301

Provider Business Practice Location Address
First Line	:	5860 RANCH LAKE BLVD
Second Line	:	SUITE A
City	:	BRADENTON
State	:	FL
Zip	:	34202-3708
Country	:	US
Telephone Number	:	941-417-8300
Fax Number	:	941-417-8301

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2007
Last Update Date	:	12/08/2015

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