IndividualActive
Ajay Mampilly
NPI 1073947321 · Physical Therapy Assistant · Emerson, NJ
Provider details
- NPI number
- 1073947321
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 40QB00300600 (NJ)
Mailing address
67 Rollinson St
West Orange, NJ 07052-4625
Registry dates
- Enumerated
- 2013-08-22
- Last updated
- 2013-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.