Provider Demographics
NPI:1528485042
Name:JAMWAL, SAKSHI (PT)
Entity type:Individual
Prefix:
First Name:SAKSHI
Middle Name:
Last Name:JAMWAL
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 1:174 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4803
Mailing Address - Country:US
Mailing Address - Phone:914-328-8077
Mailing Address - Fax:914-328-6083
Practice Address - Street 1:176 GRAND ST
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4803
Practice Address - Country:US
Practice Address - Phone:914-328-6080
Practice Address - Fax:914-328-6081
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036640225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
G400136244Medicare PIN
NYA400101012Medicare PIN
NYA400101817Medicare PIN