Provider Demographics
NPI:1861645491
Name:SANGHANI, NISHTHA C (PT)
Entity Type:Individual
Prefix:MRS
First Name:NISHTHA
Middle Name:C
Last Name:SANGHANI
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 1:13909 DAIRY FARM DR
Mailing Address - Street 2:
Mailing Address - City:BOYDS
Mailing Address - State:MD
Mailing Address - Zip Code:20841-4228
Mailing Address - Country:US
Mailing Address - Phone:240-476-7999
Mailing Address - Fax:
Practice Address - Street 1:12321 MIDDLEBROOK RD STE 103
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-1512
Practice Address - Country:US
Practice Address - Phone:310-428-1070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD140442208100000X
MD21295225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD140442OtherSTATE OF MD