Provider Demographics
NPI:1144547092
Name:MAKANI, KRUTIBEN JAYANTILAL (MSPT)
Entity type:Individual
Prefix:MS
First Name:KRUTIBEN
Middle Name:JAYANTILAL
Last Name:MAKANI
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
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Mailing Address - Street 1:3514 MERMAID AVE
Mailing Address - Street 2:SUITE 003
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-1508
Mailing Address - Country:US
Mailing Address - Phone:718-996-1100
Mailing Address - Fax:646-514-4800
Practice Address - Street 1:81 WILLOUGHBY ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5291
Practice Address - Country:US
Practice Address - Phone:718-522-2033
Practice Address - Fax:646-514-4800
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY032340225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist