Provider Demographics
NPI:1811037039
Name:BISNAUTH, TANUJA TAJWATTIE
Entity Type:Individual
Prefix:MRS
First Name:TANUJA
Middle Name:TAJWATTIE
Last Name:BISNAUTH
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TAJWATTIE
Other - Middle Name:
Other - Last Name:RAMESHWAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:979 CROSS BRONX EXPY
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-4885
Mailing Address - Country:US
Mailing Address - Phone:718-665-7565
Mailing Address - Fax:718-665-7595
Practice Address - Street 1:979 CROSS BRONX EXPY
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-4885
Practice Address - Country:US
Practice Address - Phone:718-665-7565
Practice Address - Fax:718-665-7595
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005879-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant