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General NPI Number Information
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NPI Number | 1366577371
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Entity Type | Individual
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Provider Name | NAMRATA NIMESH DIKSHIT MAPT
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Gender | Female
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 1030 SAINT GEORGES AVE STE LL3
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City | AVENEL
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State | NJ
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Zip | 07001-1330
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Country | US
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Telephone | 732-404-1040
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Fax | 732-404-1041
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Provider Business Mailing Address
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Address Line | 1030 SAINT GEORGES AVE STE LL3
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City | AVENEL
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State | NJ
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Zip | 07001-1330
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Country | US
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Telephone | 732-404-1040
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Fax | 732-404-1041
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251H1300X
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Taxonomy Name | Human Factors Physical Therapist
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License Number | 40QA0006295
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License Number State | NJ
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