Provider Demographics
NPI:1538438262
Name:BLIMLINE, GAURI
Entity type:Individual
Prefix:
First Name:GAURI
Middle Name:
Last Name:BLIMLINE
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 1:20 RIVER CT
Mailing Address - Street 2:APT 1612
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07310-2201
Mailing Address - Country:US
Mailing Address - Phone:201-234-9016
Mailing Address - Fax:
Practice Address - Street 1:20 RIVER CT
Practice Address - Street 2:APT 1612
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07310-2201
Practice Address - Country:US
Practice Address - Phone:201-234-9016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-27
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033829225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist