Provider Demographics
NPI:1013615046
Name:ACTIVE PHYSICAL THERAPY AND CHIROPRACTIC GROUP
Entity type:Organization
Organization Name:ACTIVE PHYSICAL THERAPY AND CHIROPRACTIC GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PUJA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAIKWAD
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:201-993-1195
Mailing Address - Street 1:369 LEXINGTON AVENUE
Mailing Address - Street 2:26TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6546
Mailing Address - Country:US
Mailing Address - Phone:212-951-1483
Mailing Address - Fax:
Practice Address - Street 1:110 E 66TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6504
Practice Address - Country:US
Practice Address - Phone:212-837-8855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty