Provider Demographics
NPI:1487356002
Name:ALTMAN, JOE (PEER SPECIALIST)
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:PEER SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 HENRY ST FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-6439
Mailing Address - Country:US
Mailing Address - Phone:646-280-9620
Mailing Address - Fax:
Practice Address - Street 1:201 HENRY ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-6439
Practice Address - Country:US
Practice Address - Phone:646-280-9620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYCPS-1157175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist