Provider Demographics
NPI:1174808455
Name:JANI, HIMANI
Entity type:Individual
Prefix:
First Name:HIMANI
Middle Name:
Last Name:JANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 77TH ST
Mailing Address - Street 2:# 7
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-5616
Mailing Address - Country:US
Mailing Address - Phone:267-250-5830
Mailing Address - Fax:
Practice Address - Street 1:88 MAIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:LITTLE FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07424-1412
Practice Address - Country:US
Practice Address - Phone:877-887-3574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-18
Last Update Date:2019-07-19
Deactivation Date:2019-05-22
Deactivation Code:
Reactivation Date:2019-07-19
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01419700171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor