Healthcare Provider Details

I. General information

NPI: 1871497370
Provider Name (Legal Business Name): SHRUTIBEN NARESHKUMAR KUMBHANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 LAIDLAW AVE APT 1
JERSEY CITY NJ
07306-2512
US

IV. Provider business mailing address

161 LAIDLAW AVE APT 1
JERSEY CITY NJ
07306-2512
US

V. Phone/Fax

Practice location:
  • Phone: 657-517-6528
  • Fax:
Mailing address:
  • Phone: 657-517-6528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3967661
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: