Healthcare Provider Details

I. General information

NPI: 1881146348
Provider Name (Legal Business Name): JANICE VIYAR PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2016
Last Update Date: 11/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 CLIFTON AVE STE 211
CLIFTON NJ
07013-3525
US

IV. Provider business mailing address

416 BELLEVILLE AVE
BELLEVILLE NJ
07109-1615
US

V. Phone/Fax

Practice location:
  • Phone: 973-837-6212
  • Fax: 973-837-6215
Mailing address:
  • Phone: 909-272-4359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01697500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: