Provider Demographics
NPI:1184680050
Name:ARTHUNGAL, JASON (MS PT)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:ARTHUNGAL
Suffix:
Gender:M
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 1:118 MELROSE DR
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-4612
Mailing Address - Country:US
Mailing Address - Phone:914-497-3400
Mailing Address - Fax:
Practice Address - Street 1:179TH STREET AND LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:ST. ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11425-0001
Practice Address - Country:US
Practice Address - Phone:718-526-1000
Practice Address - Fax:718-298-8531
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025971225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist