Provider Demographics
NPI:1891934840
Name:GULATI, CHANDNI (PT)
Entity Type:Individual
Prefix:
First Name:CHANDNI
Middle Name:
Last Name:GULATI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHANDNI
Other - Middle Name:
Other - Last Name:CHOPRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:79 OVERLOOK CIR
Mailing Address - Street 2:
Mailing Address - City:GARNET VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19060-2251
Mailing Address - Country:US
Mailing Address - Phone:732-593-9918
Mailing Address - Fax:
Practice Address - Street 1:79 OVERLOOK CIR
Practice Address - Street 2:
Practice Address - City:GARNET VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19060-2251
Practice Address - Country:US
Practice Address - Phone:732-593-9918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-16
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501013114225100000X
PAPT019712225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist