Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251G0304X | Physical Therapist - Geriatrics | 019510 | NY |
Y | 2251G0304X | Physical Therapist - Geriatrics | 40QA00978900 | NJ |
NPI | 1164648481 |
---|---|
Provider Name | Dr. Richard S. Holsman |
First Address | Belleville, NJ 07109-5306 |
Second Address | Belleville, NJ 07109-5318 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 14/09/2013 |