Provider Demographics
NPI:1073038345
Name:CHAUDHARI, HIRAL (PT)
Entity Type:Individual
Prefix:
First Name:HIRAL
Middle Name:
Last Name:CHAUDHARI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 1/2 TERRACE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-4154
Mailing Address - Country:US
Mailing Address - Phone:216-924-3935
Mailing Address - Fax:
Practice Address - Street 1:157 1/2 TERRACE AVE FL 2
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-4154
Practice Address - Country:US
Practice Address - Phone:216-924-3935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010815225200000X
NY041928225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY010815OtherPHYSICAL THERAPY ASSISTANT
NY041928OtherPHYSICAL THERAPIST