Provider Demographics
NPI:1508684861
Name:PANDYA, PRANJALI HIREN (PTA)
Entity type:Individual
Prefix:
First Name:PRANJALI
Middle Name:HIREN
Last Name:PANDYA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:646 MONTGOMERY ST APT 1F
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-2764
Mailing Address - Country:US
Mailing Address - Phone:551-328-5151
Mailing Address - Fax:
Practice Address - Street 1:7 W 45TH ST FL 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-4905
Practice Address - Country:US
Practice Address - Phone:212-867-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014334225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant