Provider Demographics
NPI:1518667641
Name:PASPULATI, JYOTHIRMAYEE (PT)
Entity Type:Individual
Prefix:
First Name:JYOTHIRMAYEE
Middle Name:
Last Name:PASPULATI
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 1:82 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-3633
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21 CLARK ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3648
Practice Address - Country:US
Practice Address - Phone:347-343-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2024-03-20
Deactivation Date:2024-03-12
Deactivation Code:
Reactivation Date:2024-03-19
Provider Licenses
StateLicense IDTaxonomies
NY052132225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist