Provider Demographics
NPI:1326371220
Name:MANGAL, HEMANSU (DPT (DOCTOR OF PT))
Entity Type:Individual
Prefix:
First Name:HEMANSU
Middle Name:
Last Name:MANGAL
Suffix:
Gender:M
Credentials:DPT (DOCTOR OF PT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HAMILTON PL
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-6821
Mailing Address - Country:US
Mailing Address - Phone:917-334-9285
Mailing Address - Fax:
Practice Address - Street 1:101 HAMILTON PL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-6821
Practice Address - Country:US
Practice Address - Phone:917-334-9285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030575225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist