Provider Demographics
NPI:1497052807
Name:MAHAJAN, NEHA (PT)
Entity Type:Individual
Prefix:
First Name:NEHA
Middle Name:
Last Name:MAHAJAN
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 1:9 CREEKSIDE CT
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-3750
Mailing Address - Country:US
Mailing Address - Phone:201-294-6064
Mailing Address - Fax:
Practice Address - Street 1:9 CREEKSIDE CT
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-3750
Practice Address - Country:US
Practice Address - Phone:848-248-2266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-21
Last Update Date:2019-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031934-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist