Basic Information
| Provider Information | |||||||||
| NPI: | 1215492780 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JOSHUA | ||||||||
| FirstName: | ATARAH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 179 BEAR HILL RD STE 105 | ||||||||
| Address2: | |||||||||
| City: | WALTHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024511063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818959500 | ||||||||
| FaxNumber: | 7818954800 | ||||||||
| Practice Location | |||||||||
| Address1: | 179 BEAR HILL RD STE 105 | ||||||||
| Address2: | |||||||||
| City: | WALTHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024511063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818959500 | ||||||||
| FaxNumber: | 7818954800 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2019 | ||||||||
| LastUpdateDate: | 02/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251N0400X | 24081 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Neurology |
No ID Information.