Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1881113280 |
---|---|
Provider Name | Dr. Jayashree Shrikant Pathak |
First Address | Iselin, NJ 08830-2980 |
Second Address | East Orange, NJ 07018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2017 |
Last Update Date | 17/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
38829497 | THE INTERNATIONAL ASSOCIATION OF YOGA THERAPISTS (01) | |
5815 | MEDICAL COUNCIL OF MADHYA PRADESH, BHOPAL, 1984 (01) |