Provider Demographics
NPI:1467765859
Name:CHAWLA, MANROOP KAUR (DPT)
Entity type:Individual
Prefix:DR
First Name:MANROOP
Middle Name:KAUR
Last Name:CHAWLA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 9TH AVE
Mailing Address - Street 2:APT 3C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-1609
Mailing Address - Country:US
Mailing Address - Phone:215-622-6057
Mailing Address - Fax:
Practice Address - Street 1:1140 BLACK OAK RIDGE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470
Practice Address - Country:US
Practice Address - Phone:973-835-7443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02159600225100000X
NY0308101225100000X
NY0308102251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist