Provider Demographics
NPI:1356656847
Name:BHATT, KRUNAL K (PT)
Entity Type:Individual
Prefix:
First Name:KRUNAL
Middle Name:K
Last Name:BHATT
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 1:16 COTTAGE ST
Mailing Address - Street 2:APT# 44
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-2833
Mailing Address - Country:US
Mailing Address - Phone:724-762-0197
Mailing Address - Fax:
Practice Address - Street 1:16 COTTAGE ST
Practice Address - Street 2:APT# 44
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-2833
Practice Address - Country:US
Practice Address - Phone:724-762-0197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032059225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist