MEDICARE: JYOTI S DRALL P.T

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	017606	NY

General Provider Information

NPI Number	:	1245327907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JYOTI S DRALL P.T

Provider Business Mailing Address
First Line	:	197 PEMBROOK DR
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10710-2805
Country	:	US
Telephone Number	:	914-779-3366
Fax Number	:	914-779-3366

Provider Business Practice Location Address
First Line	:	1265 FULTON AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10456-3401
Country	:	US
Telephone Number	:	718-579-7049
Fax Number	:

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

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	07/08/2007

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