Provider Demographics
NPI:1053794750
Name:GHEVARIYA, RIDDHI RASHMIKANT (PT)
Entity type:Individual
Prefix:
First Name:RIDDHI
Middle Name:RASHMIKANT
Last Name:GHEVARIYA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:RIDDHI
Other - Middle Name:VIRENDRA
Other - Last Name:JARIWALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:801 BRISTOL TRCE
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1093
Mailing Address - Country:US
Mailing Address - Phone:732-771-6620
Mailing Address - Fax:
Practice Address - Street 1:801 BRISTOL TRCE # 801
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30022-1093
Practice Address - Country:US
Practice Address - Phone:732-771-6620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1255911225100000X, 2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics