Provider Demographics
NPI:1033422936
Name:PATWARDHAN, MANALI (MS, PT)
Entity Type:Individual
Prefix:MS
First Name:MANALI
Middle Name:
Last Name:PATWARDHAN
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 NEWPORT PKWY
Mailing Address - Street 2:APT 406
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07310-1503
Mailing Address - Country:US
Mailing Address - Phone:925-348-0337
Mailing Address - Fax:
Practice Address - Street 1:10 E 33RD ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5018
Practice Address - Country:US
Practice Address - Phone:646-487-2495
Practice Address - Fax:646-487-2061
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0322392251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic