Provider Demographics
NPI:1932484102
Name:PANDYA, UTSAV YOGESHKUMAR (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:UTSAV
Middle Name:YOGESHKUMAR
Last Name:PANDYA
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 72ND ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-1036
Mailing Address - Country:US
Mailing Address - Phone:718-576-6565
Mailing Address - Fax:
Practice Address - Street 1:1353 UTICA AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-6615
Practice Address - Country:US
Practice Address - Phone:718-576-6565
Practice Address - Fax:718-576-6567
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033713225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist