Healthcare Provider Details

I. General information

NPI: 1073038345
Provider Name (Legal Business Name): HIRAL CHAUDHARI PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2017
Last Update Date: 05/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 1/2 TERRACE AVE FL 2
JERSEY CITY NJ
07307-4154
US

IV. Provider business mailing address

157 1/2 TERRACE AVE FL 2
JERSEY CITY NJ
07307-4154
US

V. Phone/Fax

Practice location:
  • Phone: 216-924-3935
  • Fax:
Mailing address:
  • Phone: 216-924-3935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number041928
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number010815
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: