MEDICARE: TAPAN KIKANI PT, PHD

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	PT008842E	PA

General Provider Information

NPI Number	:	1750858528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAPAN KIKANI PT, PHD

Provider Business Mailing Address
First Line	:	106 BLUE JAY WAY
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-4282
Country	:	US
Telephone Number	:	215-429-0331
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 BLUE JAY WAY
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-4282
Country	:	US
Telephone Number	:	215-429-0331
Fax Number	:

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

Provider Enumeration Date	:	10/30/2018
Last Update Date	:	10/30/2018

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