Healthcare Provider Details

I. General information

NPI: 1164353702
Provider Name (Legal Business Name): HITARTH D MAKWANA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8709 JUSTICE AVE STE 1
ELMHURST NY
11373-4690
US

IV. Provider business mailing address

8709 JUSTICE AVE STE 1
ELMHURST NY
11373-4690
US

V. Phone/Fax

Practice location:
  • Phone: 718-699-5070
  • Fax:
Mailing address:
  • Phone: 718-699-5070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number015265-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: