Provider Demographics
NPI:1114701174
Name:RAVAL, POOJA (DPT)
Entity type:Individual
Prefix:
First Name:POOJA
Middle Name:
Last Name:RAVAL
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 US HIGHWAY 206 STE E
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-1511
Mailing Address - Country:US
Mailing Address - Phone:908-262-7719
Mailing Address - Fax:732-970-7883
Practice Address - Street 1:668 US HIGHWAY 206 STE E
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1511
Practice Address - Country:US
Practice Address - Phone:908-262-7719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB003650500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist