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General NPI Number Information
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NPI Number | 1487477907
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Entity Type | Individual
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Provider Name | MRS. JOTHSNA MED KACHARAM
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Gender | Female
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | ELITE ORTHOPEDIC AND REHABILITATION 253 ROUTE 211 E
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City | MIDDLETOWN
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State | NY
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Zip | 10940
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Country | US
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Telephone | 917-318-5303
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Fax |
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Provider Business Mailing Address
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Address Line | VICTORY PHYSICAL THERAPY P.C. 2550 VICTORY BLVD - SUITE 301
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City | STATEN ISLAND
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State | NY
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Zip | 10314
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Country | US
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Telephone | 917-318-5303
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 049781
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License Number State | NY
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