Provider Demographics
NPI:1922317825
Name:PANCHAL, NEEMA NITIN (MOTR/L)
Entity Type:Individual
Prefix:MRS
First Name:NEEMA
Middle Name:NITIN
Last Name:PANCHAL
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6930B 186TH LN
Mailing Address - Street 2:APT. 2C
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-4408
Mailing Address - Country:US
Mailing Address - Phone:704-258-7592
Mailing Address - Fax:
Practice Address - Street 1:6930B 186TH LN
Practice Address - Street 2:APT. 2C
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-4408
Practice Address - Country:US
Practice Address - Phone:704-258-7592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012350225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist