Provider Demographics
NPI:1316316144
Name:THUMMAR, JALPABEN CHIMANLAL (PT)
Entity type:Individual
Prefix:
First Name:JALPABEN
Middle Name:CHIMANLAL
Last Name:THUMMAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:752 COUNTY AVE
Mailing Address - Street 2:APT # 1A
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-2730
Mailing Address - Country:US
Mailing Address - Phone:551-574-8549
Mailing Address - Fax:
Practice Address - Street 1:191 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1112
Practice Address - Country:US
Practice Address - Phone:201-656-4324
Practice Address - Fax:201-656-4019
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038533225100000X
TX1256050225100000X
NJ40QA01755400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04544161Medicaid
NY1316316144Other1199 SEIU FUNDS
NY201618900046OtherAFFINITY
NYP0104147OtherELDER PLAN
NYG400342043Medicare PIN