Provider Demographics
NPI:1417740234
Name:NANDALAL, AVANI DEVI (OTR/L)
Entity type:Individual
Prefix:MS
First Name:AVANI
Middle Name:DEVI
Last Name:NANDALAL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CLUETT RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-2503
Mailing Address - Country:US
Mailing Address - Phone:516-204-2010
Mailing Address - Fax:
Practice Address - Street 1:30 CLUETT RD
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-2503
Practice Address - Country:US
Practice Address - Phone:516-204-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-24
Last Update Date:2025-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPENDING225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist