MEDICARE: MUKTA CHAUHAN PT, DPT

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	031011	NY

General Provider Information

NPI Number	:	1790012144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUKTA CHAUHAN PT, DPT

Provider Business Mailing Address
First Line	:	215 W 95TH ST APT 14F
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10025-9811
Country	:	US
Telephone Number	:	845-891-8150
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 W 95TH ST APT 14F
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10025-9811
Country	:	US
Telephone Number	:	845-891-8150
Fax Number	:

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

Provider Enumeration Date	:	11/05/2009
Last Update Date	:	02/04/2024

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