Provider Demographics
NPI:1821885906
Name:SHRESTHA, DARSHANA
Entity type:Individual
Prefix:MISS
First Name:DARSHANA
Middle Name:
Last Name:SHRESTHA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2022 EVERGREEN TERRACE DR E APT 6
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901-3918
Mailing Address - Country:US
Mailing Address - Phone:618-434-5117
Mailing Address - Fax:
Practice Address - Street 1:200 PETERSVILLE RD
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-4465
Practice Address - Country:US
Practice Address - Phone:914-650-3448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052363-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist