Provider Demographics
NPI:1336907336
Name:SHINDE, SHARWARI SANJAY (PT)
Entity Type:Individual
Prefix:
First Name:SHARWARI
Middle Name:SANJAY
Last Name:SHINDE
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 1:2531 STEINWAY ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-3788
Mailing Address - Country:US
Mailing Address - Phone:929-463-7104
Mailing Address - Fax:929-463-3149
Practice Address - Street 1:2531 STEINWAY ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-3788
Practice Address - Country:US
Practice Address - Phone:929-463-7104
Practice Address - Fax:929-463-3149
Is Sole Proprietor?:No
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051543225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist