Provider Demographics
NPI:1437860392
Name:TYAGI, GARGI
Entity Type:Individual
Prefix:
First Name:GARGI
Middle Name:
Last Name:TYAGI
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 1:16N GREENBUSH RD SUITE 2003
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-8581
Mailing Address - Country:US
Mailing Address - Phone:518-326-3771
Mailing Address - Fax:
Practice Address - Street 1:16 N GREENBUSH RD STE 203
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-8581
Practice Address - Country:US
Practice Address - Phone:518-326-3771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047294225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist