MEDICARE: DR. KIANA WEARY

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	055502	NY
2	225100000X	Physical Therapist	307524	CA
3	225100000X	Physical Therapist	PTL26407	MA

General Provider Information

NPI Number	:	1871445965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIANA WEARY

Provider Business Mailing Address
First Line	:	132 YALE AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07304-4138
Country	:	US
Telephone Number	:	901-428-9493
Fax Number	:

Provider Business Practice Location Address
First Line	:	132 YALE AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07304-4138
Country	:	US
Telephone Number	:	901-428-9493
Fax Number	:

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

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “ DR. KIANA WEARY ” Practice Location

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