MEDICARE: MASOOM HITESH KOTECHA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1184519456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MASOOM HITESH KOTECHA

Provider Business Mailing Address
First Line	:	201 SAINT PAULS AVE APT 14G
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-3766
Country	:	US
Telephone Number	:	716-818-9560
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 SAINT PAULS AVE APT 14G
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-3766
Country	:	US
Telephone Number	:	716-818-9560
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2025
Last Update Date	:	06/09/2025

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Directions to “ MASOOM HITESH KOTECHA ” Practice Location

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