Provider Demographics
NPI:1942544259
Name:PANDYA, DOLLY SHASHIKANT (PT)
Entity Type:Individual
Prefix:MISS
First Name:DOLLY
Middle Name:SHASHIKANT
Last Name:PANDYA
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 1:514 N HARRIS RD # 1
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-4121
Mailing Address - Country:US
Mailing Address - Phone:734-637-7540
Mailing Address - Fax:
Practice Address - Street 1:514 N HARRIS RD # 1
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-4121
Practice Address - Country:US
Practice Address - Phone:734-637-7540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501015979225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist