Provider Demographics
NPI:1760023287
Name:VERMA, SHALINI (MPT, PHD)
Entity Type:Individual
Prefix:
First Name:SHALINI
Middle Name:
Last Name:VERMA
Suffix:
Gender:F
Credentials:MPT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11766 127TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-2808
Mailing Address - Country:US
Mailing Address - Phone:917-847-6758
Mailing Address - Fax:
Practice Address - Street 1:11766 127TH ST
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420-2808
Practice Address - Country:US
Practice Address - Phone:917-847-6758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-06
Last Update Date:2019-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043828225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty