MEDICARE: DR. ROHINI VIRA PHD, LMFT

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	106H00000X	Marriage & Family Therapist	000677	NY
2	106H00000X	Marriage & Family Therapist	4101006284	MI
3	106H00000X	Marriage & Family Therapist	LF 60042004	WA
4	106H00000X	Marriage & Family Therapist	37FI00167000	NJ

General Provider Information

NPI Number	:	1659572154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROHINI VIRA PHD, LMFT

Provider Business Mailing Address
First Line	:	50 HARRISON STREET
Second Line	:	SUITE 212-A
City	:	HOBOKEN
State	:	NJ
Zip	:	07030
Country	:	US
Telephone Number	:	917-328-5926
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 WASHINGTON BLVD
Second Line	:	3205
City	:	JERSEY CITY
State	:	NJ
Zip	:	07310
Country	:	US
Telephone Number	:	917-328-5926
Fax Number	:

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

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	02/25/2011

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