Provider Demographics
NPI:1699300301
Name:RANA, PAYAL
Entity type:Individual
Prefix:
First Name:PAYAL
Middle Name:
Last Name:RANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 GREGORY AVE APT 12
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-4830
Mailing Address - Country:US
Mailing Address - Phone:862-295-6491
Mailing Address - Fax:
Practice Address - Street 1:89 GREGORY AVE APT 12
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-4830
Practice Address - Country:US
Practice Address - Phone:862-295-6491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04572101225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist