Provider Demographics
NPI:1023781788
Name:CHOGLE, DEEVESHRI NILAN (DPT)
Entity type:Individual
Prefix:MS
First Name:DEEVESHRI
Middle Name:NILAN
Last Name:CHOGLE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:320 E 93RD ST APT 1B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5532
Mailing Address - Country:US
Mailing Address - Phone:909-602-7624
Mailing Address - Fax:
Practice Address - Street 1:67 W 55TH ST STE 204
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-4902
Practice Address - Country:US
Practice Address - Phone:212-759-4553
Practice Address - Fax:212-486-8334
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY46799225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist