Provider Demographics
NPI:1700116068
Name:INAGALLA, RAJYA LAKSHMI (PT)
Entity Type:Individual
Prefix:
First Name:RAJYA
Middle Name:LAKSHMI
Last Name:INAGALLA
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 1:718 COVE RD
Mailing Address - Street 2:APT 7
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-5437
Mailing Address - Country:US
Mailing Address - Phone:203-276-1241
Mailing Address - Fax:
Practice Address - Street 1:1200 KING ST
Practice Address - Street 2:
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-7000
Practice Address - Country:US
Practice Address - Phone:917-864-7706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-10
Last Update Date:2010-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031113225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist