| Doctor Name: | PHANI JAYA SREE KAZA |
| NPI Number: | 1871883249 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | 032443 |
| Business Practice Address: | 260 Middle Country Rd Bldg.3, Suite 9-a Selden, NY - 117842568 |
| Business Phone Number: | 6317321600 |
| Business Fax Number: | 6317327872 |
| Mailing Address: | 1904 Village Dr, AVENEL |
| State: | NJ |
| Postal Code: | 070011048 |
| Phone Number: | 9167534534 |
| Fax Number: | |
| NPI Enumeration Date: | 04/19/2011 |
| NPI Last Update Date: | 04/19/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 032443 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| 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 |