Healthcare Provider Details

I. General information

NPI: 1942135611
Provider Name (Legal Business Name): AMEYA PUJARI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1963 GRAND CONCOURSE FL 2
BRONX NY
10453-4995
US

IV. Provider business mailing address

9901 63RD RD
REGO PARK NY
11374-1939
US

V. Phone/Fax

Practice location:
  • Phone: 718-466-4600
  • Fax: 718-466-1100
Mailing address:
  • Phone: 718-509-9424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number055935
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: