MEDICARE: YOGESH TIWARI OTR/L

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	225XG0600X	Gerontology Occupational Therapist	46TR00174600	NJ

General Provider Information

NPI Number	:	1194179259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOGESH TIWARI OTR/L

Provider Business Mailing Address
First Line	:	17 CLIFTON TER
Second Line	:
City	:	ENGLEWOOD CLIFFS
State	:	NJ
Zip	:	07632-3016
Country	:	US
Telephone Number	:	201-694-0169
Fax Number	:	201-567-5423

Provider Business Practice Location Address
First Line	:	17 CLIFTON TER
Second Line	:
City	:	ENGLEWOOD CLIFFS
State	:	NJ
Zip	:	07632-3016
Country	:	US
Telephone Number	:	201-694-0169
Fax Number	:	201-567-5423

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

Provider Enumeration Date	:	04/14/2016
Last Update Date	:	04/14/2016

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