Provider Demographics
NPI:1881734127
Name:RATTIEN, JOSEPH SAMUEL (DPT)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:SAMUEL
Last Name:RATTIEN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:
Other - Last Name:RATTIEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:440 BALD EAGLE DRIVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312
Mailing Address - Country:US
Mailing Address - Phone:919-345-9196
Mailing Address - Fax:919-277-9942
Practice Address - Street 1:1001 SHELDON DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2078
Practice Address - Country:US
Practice Address - Phone:919-345-9196
Practice Address - Fax:919-277-9942
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2012-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027209225100000X
NC11309225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJR0Q25V510Medicare ID - Type Unspecified
NC250242AMedicare PIN