Individual
STEVEN BISSOONDIAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
351 UNION BLVD, TOTOWA, NJ 07512-2556
(862) 239-1768
Mailing address
9 SUNBURST LN, WAYNE, NJ 07470-4955
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00359400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QB00359400
NEW JERSEY STATE LICENSE NUMBER
NJ
Enumeration date
03/05/2019
Last updated
03/05/2019
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