Provider Demographics
NPI:1285216028
Name:PANDYA, RUTVIK J (PT)
Entity Type:Individual
Prefix:
First Name:RUTVIK
Middle Name:J
Last Name:PANDYA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:RUTVIK
Other - Middle Name:JANAK
Other - Last Name:PANDYA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:581 AVALON GARDENS DR
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-7435
Mailing Address - Country:US
Mailing Address - Phone:862-621-8993
Mailing Address - Fax:
Practice Address - Street 1:581 AVALON GARDENS DR
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-7435
Practice Address - Country:US
Practice Address - Phone:862-621-8993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046205225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist