Provider Demographics
NPI:1497532931
Name:KRISHNA PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:KRISHNA PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DIVIK
Authorized Official - Middle Name:
Authorized Official - Last Name:BHASIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-534-8086
Mailing Address - Street 1:246 RYDERS LN
Mailing Address - Street 2:
Mailing Address - City:MILLTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08850-1353
Mailing Address - Country:US
Mailing Address - Phone:732-246-3585
Mailing Address - Fax:732-400-8474
Practice Address - Street 1:246 RYDERS LN
Practice Address - Street 2:
Practice Address - City:MILLTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08850-1353
Practice Address - Country:US
Practice Address - Phone:732-246-3585
Practice Address - Fax:732-400-8474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation