Basic Information
| Provider Information | |||||||||
| NPI: | 1013462167 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | BAJAJ | ||||||||
| FirstName: | SRISHTI | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 635 PARK RD | ||||||||
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| City: | MORRIS PLAINS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079502833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454164476 | ||||||||
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| Practice Location | |||||||||
| Address1: | 150 55TH ST | ||||||||
| Address2: | STATION 3-05 | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112202508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186308214 | ||||||||
| FaxNumber: | 7186307604 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2016 | ||||||||
| LastUpdateDate: | 08/18/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 040336 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.