MEDICARE: NIHARIKA JAISWAL P.T.

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
1	225100000X	Physical Therapist	031747	NY

General Provider Information

NPI Number	:	1326379116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIHARIKA JAISWAL P.T.

Provider Business Mailing Address
First Line	:	2187 CRUGER AVE
Second Line	:	APT 5 J
City	:	BRONX
State	:	NY
Zip	:	10462-1540
Country	:	US
Telephone Number	:	757-675-2127
Fax Number	:

Provider Business Practice Location Address
First Line	:	506 LENOX AVE
Second Line	:	MLK BUILDING, ROOM 3137
City	:	NEW YORK
State	:	NY
Zip	:	10037-1802
Country	:	US
Telephone Number	:	212-939-4442
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2010
Last Update Date	:	01/19/2010

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