Provider Demographics
NPI:1053399733
Name:CHADHA, GURJEET (DPT)
Entity type:Individual
Prefix:
First Name:GURJEET
Middle Name:
Last Name:CHADHA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:730 COLUMBUS AVE
Mailing Address - Street 2:BRICK-RUN SPORTS PHYSICAL THERAPY, PLLC
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6658
Mailing Address - Country:US
Mailing Address - Phone:212-665-5070
Mailing Address - Fax:212-665-5077
Practice Address - Street 1:730 COLUMBUS AVE
Practice Address - Street 2:BRICK-RUN SPORTS PHYSICAL THERAPY, PLLC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6658
Practice Address - Country:US
Practice Address - Phone:212-665-5070
Practice Address - Fax:212-665-5077
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY22056225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQN8901Medicare UPIN
NYQN8901Medicare Oscar/Certification