Smita Pankaj Ajmera, RPT

Individual provider Active NPI Physical Therapy Clinic/Center · Fremont, CA

NPI 1972849495 · NPPES record last updated Jan 2, 2013

Key facts

NPI
1972849495
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Clinic/Center 261QP2000X
License
PT 16073 (CA)
Practice address
3550 Mowry Ave
Suite 101
Fremont, CA 94538-1460
Phone
(510) 676-4087
Fax
(510) 745-0192
NPI assigned
Jan 2, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT 16073CAMDPhysical Therapy Clinic/Center

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT 16073 CA Yes

Addresses

Primary practice location

3550 Mowry Ave
Suite 101
Fremont, CA 94538-1460

Mailing address

34346 Agate Ter
Fremont, CA 94555-3858
Phone (510) 676-4087

Other providers in Fremont, CA

All providers in Fremont, CA · Physical Therapy Clinic/Center in California

Sources for this page

Verify at the official NPI Registry.