Healthcare Provider Details

I. General information

NPI: 1417661133
Provider Name (Legal Business Name): JANAK PT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2023
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 HINE ST STE 103
PATERSON NJ
07503-2955
US

IV. Provider business mailing address

614 MOLA BLVD
ELMWOOD PARK NJ
07407-1343
US

V. Phone/Fax

Practice location:
  • Phone: 973-358-5500
  • Fax: 973-358-5501
Mailing address:
  • Phone: 201-290-0416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: VIPUL PATEL
Title or Position: OWNER
Credential:
Phone: 201-290-0416