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NPI Code Detail

MEDICARE: YASH ABHAY RAOLE

MEDICARE: YASH ABHAY RAOLE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist40QA02261900NJ

General Provider Information

NPI Number : 1205672516
Entity Type Code : Individual
Provider Name (Legal Business Name) : YASH ABHAY RAOLE
Provider Business Mailing Address
First Line : 156 FIAT AVE
Second Line :
City : ISELIN
State : NJ
Zip : 08830-1418
Country : US
Telephone Number : 732-423-5697
Fax Number :
Provider Business Practice Location Address
First Line : 2163 OAK TREE RD STE 109
Second Line :
City : EDISON
State : NJ
Zip : 08820-1084
Country : US
Telephone Number : 732-272-0083
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2024
Last Update Date : 07/05/2024

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