Provider Demographics
NPI:1295190536
Name:DUNGARANI, JITEN (PT)
Entity Type:Individual
Prefix:
First Name:JITEN
Middle Name:
Last Name:DUNGARANI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 E BART ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-3487
Mailing Address - Country:US
Mailing Address - Phone:480-703-5680
Mailing Address - Fax:
Practice Address - Street 1:1807 E QUEEN CREEK RD STE 7
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-2023
Practice Address - Country:US
Practice Address - Phone:602-666-6602
Practice Address - Fax:602-666-6167
Is Sole Proprietor?:No
Enumeration Date:2015-12-30
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035695225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist