Healthcare Provider Details

I. General information

NPI: 1558027508
Provider Name (Legal Business Name): TRUPTI MOKATI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2021
Last Update Date: 08/10/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 W 93RD ST LOWR LEVEL
NEW YORK NY
10025-7391
US

IV. Provider business mailing address

250 W 93RD ST LOWR LEVEL
NEW YORK NY
10025-7391
US

V. Phone/Fax

Practice location:
  • Phone: 212-580-0125
  • Fax: 516-466-7723
Mailing address:
  • Phone: 212-580-0125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number045757
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number045757
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: