Healthcare Provider Details

I. General information

NPI: 1801173869
Provider Name (Legal Business Name): POOJA ROHIT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: POOJA SEKHAR PT

II. Dates (important events)

Enumeration Date: 11/04/2011
Last Update Date: 04/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4949 OGLETOWN STANTON RD
NEWARK DE
19713
US

IV. Provider business mailing address

115 HAUT BRION AVE
NEWARK DE
19702-4535
US

V. Phone/Fax

Practice location:
  • Phone: 302-409-3244
  • Fax:
Mailing address:
  • Phone: 614-266-8773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ1-0003271
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number013132
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: