Provider Demographics
NPI:1376672451
Name:MISTRY, DIPIKABEN (PT)
Entity Type:Individual
Prefix:MRS
First Name:DIPIKABEN
Middle Name:
Last Name:MISTRY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 GLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1534
Mailing Address - Country:US
Mailing Address - Phone:914-907-3889
Mailing Address - Fax:914-725-4260
Practice Address - Street 1:455 CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1060
Practice Address - Country:US
Practice Address - Phone:914-907-3889
Practice Address - Fax:914-725-4260
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0131871225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q24M81OtherEMPIRE BLUE CROSS