Provider Demographics
NPI:1942924188
Name:KHABIA, VRUTIKA (PT)
Entity Type:Individual
Prefix:
First Name:VRUTIKA
Middle Name:
Last Name:KHABIA
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 1:2695 JOHN F KENNEDY BLVD APT 42
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-5792
Mailing Address - Country:US
Mailing Address - Phone:646-209-3687
Mailing Address - Fax:
Practice Address - Street 1:1423 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-3840
Practice Address - Country:US
Practice Address - Phone:347-696-1016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048283225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY048283OtherNYSED