Provider Demographics
NPI:1568808384
Name:DESAI, SUCHI HITENDRA (PT)
Entity Type:Individual
Prefix:
First Name:SUCHI
Middle Name:HITENDRA
Last Name:DESAI
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 1:9972 66TH RD APT 1AA
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4485
Mailing Address - Country:US
Mailing Address - Phone:213-280-8484
Mailing Address - Fax:
Practice Address - Street 1:21 FERNCLIFF DR
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-2068
Practice Address - Country:US
Practice Address - Phone:845-516-1670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035620225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist