Provider Demographics
NPI:1376350637
Name:PADSALA, DARSHITA BHARATBHAI
Entity type:Individual
Prefix:
First Name:DARSHITA
Middle Name:BHARATBHAI
Last Name:PADSALA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 IRVING AVE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-1321
Mailing Address - Country:US
Mailing Address - Phone:718-912-4462
Mailing Address - Fax:
Practice Address - Street 1:2114 GRAVESEND NECK RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4810
Practice Address - Country:US
Practice Address - Phone:718-908-0078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053677208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation