Provider Demographics
NPI:1902966047
Name:SALVAGIN, JOSH L (PTA)
Entity Type:Individual
Prefix:
First Name:JOSH
Middle Name:L
Last Name:SALVAGIN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OTISVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10963-2346
Mailing Address - Country:US
Mailing Address - Phone:845-386-4130
Mailing Address - Fax:
Practice Address - Street 1:2 FLETCHER ST
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-1402
Practice Address - Country:US
Practice Address - Phone:845-294-8806
Practice Address - Fax:845-294-8650
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003413-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant