Organization
ACTIVEPRO PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD HOLSMAN PT, DPT, MAT, GCS (PRESIDENT AND CEO)
(718) 355-9652
Entity
Organization
Contact information
Practice address
817 E 180TH ST, BRONX, NY 10460-1305
(718) 220-6262
(718) 355-9652
Mailing address
710 MILL ST UNIT H3, UNIT H3, BELLEVILLE, NJ 07109-5306
(973) 759-1494
(973) 759-0557
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
016043
NY
225100000X
Physical Therapist
Primary
019510
NY
225X00000X
Occupational Therapist
014206
NY
Other
Enumeration date
01/28/2014
Last updated
01/28/2014
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