Provider Demographics
NPI:1164617981
Name:JAIN, GARIMA (PT)
Entity Type:Individual
Prefix:
First Name:GARIMA
Middle Name:
Last Name:JAIN
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 1:91 ALBERT AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2502
Mailing Address - Country:US
Mailing Address - Phone:732-910-5138
Mailing Address - Fax:732-516-1518
Practice Address - Street 1:91 ALBERT AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2502
Practice Address - Country:US
Practice Address - Phone:732-910-5138
Practice Address - Fax:732-516-1518
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-14
Last Update Date:2007-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01204100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist