Joseph Ignacio Rallistan
Individual provider Active NPI Physical Therapist · Keyport, NJ
NPI 1043698566 · NPPES record last updated Nov 18, 2022
Key facts
- NPI
- 1043698566
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 40QA01608200 (NJ)
- Practice address
- 14 Provost Ave
Keyport, NJ 07735-1023 - Phone
- (205) 544-5143
- NPI assigned
- May 16, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA01608200 | NJ | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01608200 | NJ | Yes |
Addresses
Primary practice location
14 Provost Ave
Keyport, NJ 07735-1023
Mailing address
14 Provost Ave
Keyport, NJ 07735-1023
Phone (205) 544-5143
Other providers in Keyport, NJ
- Papa Ganache, LLP
- Pinnacle Treatment Centers NJ-IV
- Pinnacle Treatment Centers NJ-VII
- Pinnacle Treatment Centers NJ-VII, LLC
- Project Journey
- Regent Staffing LLC Dba Regent Healthcare Agency
- Rachel Lee Riemenschneider
- Lorrie Robayo
- Maureen Frances Rubin
- Karen R. Rutt
All providers in Keyport, NJ · Physical Therapist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.