Organization
ACTIVEPRO PHYSICAL THERAPY PC
Active
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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