Provider Demographics
NPI:1285156398
Name:RANA, SANKETKUMAR MAHESHBHAI
Entity type:Individual
Prefix:
First Name:SANKETKUMAR
Middle Name:MAHESHBHAI
Last Name:RANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 N MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-4811
Mailing Address - Country:US
Mailing Address - Phone:845-414-9115
Mailing Address - Fax:
Practice Address - Street 1:70 STARMOND AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2636
Practice Address - Country:US
Practice Address - Phone:973-930-9622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041619225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist