Provider Demographics
NPI:1104316900
Name:ALSHON, STEVEN (PTA)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:ALSHON
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 1:443 MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721-2851
Mailing Address - Country:US
Mailing Address - Phone:732-504-4599
Mailing Address - Fax:
Practice Address - Street 1:3000 HILLTOP RD
Practice Address - Street 2:
Practice Address - City:WHITING
Practice Address - State:NJ
Practice Address - Zip Code:08759-1349
Practice Address - Country:US
Practice Address - Phone:732-849-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00285300225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant