Provider Demographics
NPI:1457633638
Name:JOSHI, JANKI PRAVIN (PT)
Entity Type:Individual
Prefix:
First Name:JANKI
Middle Name:PRAVIN
Last Name:JOSHI
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 1:174 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4803
Mailing Address - Country:US
Mailing Address - Phone:914-328-8077
Mailing Address - Fax:914-328-6083
Practice Address - Street 1:6517 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-6248
Practice Address - Country:US
Practice Address - Phone:718-497-1150
Practice Address - Fax:718-417-0912
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032798225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG400056207Medicare PIN
NYA400055806Medicare PIN
NYA400055810Medicare PIN
NYA400056842Medicare PIN
NYA400056848Medicare PIN
NYA400057433Medicare PIN