Doctor Name: | SREE VISHNU POTLURI |
NPI Number: | 1013105170 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 05008901A |
Business Practice Address: | 85 Broadway 2b Jersey City, NJ - 073066353 |
Business Phone Number: | 3173715568 |
Business Fax Number: | |
Mailing Address: | 85 Broadway, 2h JERSEY CITY |
State: | NJ |
Postal Code: | 073066353 |
Phone Number: | 3173715568 |
Fax Number: | |
NPI Enumeration Date: | 10/12/2007 |
NPI Last Update Date: | 06/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 05008901A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |