Healthcare Provider Details

I. General information

NPI: 1033030747
Provider Name (Legal Business Name): MANSI V KHUNT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 RIDGE RD # 1
LYNDHURST NJ
07071-1236
US

IV. Provider business mailing address

31 RIDGE RD # 1
LYNDHURST NJ
07071-1236
US

V. Phone/Fax

Practice location:
  • Phone: 201-554-3425
  • Fax:
Mailing address:
  • Phone: 201-554-3425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number014873
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: