Provider Demographics
NPI:1184928905
Name:CHANDRA, VINITA (PT)
Entity type:Individual
Prefix:
First Name:VINITA
Middle Name:
Last Name:CHANDRA
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 1:34 W 22ND ST
Mailing Address - Street 2:NEW YORK
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5805
Mailing Address - Country:US
Mailing Address - Phone:212-255-5531
Mailing Address - Fax:
Practice Address - Street 1:34 W 22ND ST
Practice Address - Street 2:NEW YORK
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5805
Practice Address - Country:US
Practice Address - Phone:212-255-5531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-08
Last Update Date:2011-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030053225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist