Provider Demographics
NPI:1669011953
Name:BABWANI, ALNAWAZ
Entity Type:Individual
Prefix:
First Name:ALNAWAZ
Middle Name:
Last Name:BABWANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9722 57TH AVE APT 8O
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-3571
Mailing Address - Country:US
Mailing Address - Phone:347-393-6111
Mailing Address - Fax:
Practice Address - Street 1:9722 57TH AVE APT 8O
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-3571
Practice Address - Country:US
Practice Address - Phone:347-393-6111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-03
Last Update Date:2021-09-02
Deactivation Date:2020-02-24
Deactivation Code:
Reactivation Date:2021-09-02
Provider Licenses
StateLicense IDTaxonomies
NY041767225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty