Provider Demographics
NPI:1437524493
Name:VASHI, POOJA JAINISH (DPT)
Entity Type:Individual
Prefix:
First Name:POOJA
Middle Name:JAINISH
Last Name:VASHI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 VALHALLA WAY
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-5224
Mailing Address - Country:US
Mailing Address - Phone:201-640-5363
Mailing Address - Fax:317-536-3097
Practice Address - Street 1:246 CLIFTON AVE STE 5
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011
Practice Address - Country:US
Practice Address - Phone:862-899-7900
Practice Address - Fax:862-899-7901
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-02
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01643400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist