MEDICARE: MANASI MADHAV KAMAT

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	042602-1	NY

General Provider Information

NPI Number	:	1861906679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANASI MADHAV KAMAT

Provider Business Mailing Address
First Line	:	12 BROADWAY APT 3
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-5243
Country	:	US
Telephone Number	:	412-961-5451
Fax Number	:

Provider Business Practice Location Address
First Line	:	486 MCDONALD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-3812
Country	:	US
Telephone Number	:	917-295-1025
Fax Number	:

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

Provider Enumeration Date	:	12/01/2017
Last Update Date	:	12/01/2017

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