Provider Demographics
NPI:1184604951
Name:ADVANI, NALINI MOHAN (MSPT)
Entity type:Individual
Prefix:MS
First Name:NALINI
Middle Name:MOHAN
Last Name:ADVANI
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 W NEWPORT PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19804-3235
Mailing Address - Country:US
Mailing Address - Phone:302-683-0782
Mailing Address - Fax:302-683-0783
Practice Address - Street 1:617 W NEWPORT PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19804-3235
Practice Address - Country:US
Practice Address - Phone:302-683-0782
Practice Address - Fax:302-683-0783
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0001227225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE491552Medicare PIN
DEP00051339Medicare ID - Type UnspecifiedMEDICARE RAILROAD CARRIER