Provider Demographics
NPI:1457426603
Name:WONG, JOTI MELWANI (PT, MA, DPT)
Entity type:Individual
Prefix:DR
First Name:JOTI
Middle Name:MELWANI
Last Name:WONG
Suffix:
Gender:F
Credentials:PT, MA, DPT
Other - Prefix:DR
Other - First Name:JOTI
Other - Middle Name:
Other - Last Name:MELWANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, MA, DPT
Mailing Address - Street 1:1901 1ST AVE
Mailing Address - Street 2:RM 327
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-7404
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1901 1ST AVE
Practice Address - Street 2:ROOM 327
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-7404
Practice Address - Country:US
Practice Address - Phone:212-423-7723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015886-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist