Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 027005 | NY |
NPI | 1003061490 |
---|---|
Provider Name | Dr. Tejal Gordhan Levitt |
First Address | Jersey City, NJ 07305-5431 |
Second Address | Jersey City, NJ 07305-5431 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2008 |
Last Update Date | 26/11/2008 |