Provider Demographics
NPI:1144095779
Name:CRISAFI, JOSEPH BIAGIO
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:BIAGIO
Last Name:CRISAFI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 STONE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-4132
Mailing Address - Country:US
Mailing Address - Phone:908-514-9355
Mailing Address - Fax:
Practice Address - Street 1:7 CENTRE DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-1565
Practice Address - Country:US
Practice Address - Phone:609-498-7422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01142900225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics