Individual
EVA MOHANTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
608 MERRYWOOD DR, EDISON, NJ 08817-2535
(732) 910-3995
Mailing address
608 MERRYWOOD DR, EDISON, NJ 08817-2535
(732) 910-3995
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
40QA01061600
NJ
252Y00000X
Early Intervention Provider Agency
40QA01061600
NJ
Other
Enumeration date
08/08/2012
Last updated
08/08/2012
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