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General NPI Number Information
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NPI Number | 1013615046
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Entity Type | Organization
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Legal Business Name | ACTIVE PHYSICAL THERAPY AND CHIROPRACTIC GROUP
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | 110 E 66TH ST
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City | NEW YORK
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State | NY
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Zip | 10065-6504
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Country | US
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Telephone | 212-837-8855
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Fax |
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Provider Business Mailing Address
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Address Line | 369 LEXINGTON AVENUE 26TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10017-6546
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Country | US
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Telephone | 212-951-1483
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DR. PUJA GAIKWAD
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Credential | PT, DPT
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Telephone | 201-993-1195
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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