Provider Demographics
NPI:1124876727
Name:RISOLI, JOSEPH J (DPT)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
Last Name:RISOLI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 VERONA DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-8117
Mailing Address - Country:US
Mailing Address - Phone:908-397-7982
Mailing Address - Fax:
Practice Address - Street 1:355 N COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-4426
Practice Address - Country:US
Practice Address - Phone:732-833-1133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02249000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist