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NPI Code Detail

MEDICARE: KIRTI SHETTY M.P.T

MEDICARE: KIRTI SHETTY M.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
1225100000XPhysical Therapist40QA01482500NJ
2225100000XPhysical Therapist033792NY

General Provider Information

NPI Number : 1255671285
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRTI SHETTY M.P.T
Provider Business Mailing Address
First Line : 45 COTTAGE ST
Second Line : APT # 4
City : JERSEY CITY
State : NJ
Zip : 07306-2800
Country : US
Telephone Number : 201-912-6420
Fax Number :
Provider Business Practice Location Address
First Line : 3161 KENNEDY BLVD
Second Line :
City : NORTH BERGEN
State : NJ
Zip : 07047-2303
Country : US
Telephone Number : 201-937-2758
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2013
Last Update Date : 02/28/2013

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Directions to “ KIRTI SHETTY M.P.T” Practice Location

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