Provider Demographics
NPI:1700566247
Name:MISTRY, BIJALKUMARI (PT)
Entity Type:Individual
Prefix:MRS
First Name:BIJALKUMARI
Middle Name:
Last Name:MISTRY
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 1:3814 CREEKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-2134
Mailing Address - Country:US
Mailing Address - Phone:502-938-9904
Mailing Address - Fax:
Practice Address - Street 1:2400 ARNOLD PALMER BLVD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-3222
Practice Address - Country:US
Practice Address - Phone:502-694-3740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007782225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist