Basic Information
| Provider Information | |||||||||
| NPI: | 1972100030 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PUROHIT | ||||||||
| FirstName: | HET | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 90 COURT HOUSE PL APT 3F | ||||||||
| Address2: | |||||||||
| City: | JERSEY CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 073061730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8486673807 | ||||||||
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| Practice Location | |||||||||
| Address1: | 610 WASHINGTON BLVD | ||||||||
| Address2: | |||||||||
| City: | JERSEY CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 073101400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122273233 | ||||||||
| FaxNumber: | 8665495687 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2020 | ||||||||
| LastUpdateDate: | 10/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 029250 | NJ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.