Provider Demographics
NPI:1972364891
Name:RAVAL, DHAIRYA
Entity type:Individual
Prefix:DR
First Name:DHAIRYA
Middle Name:
Last Name:RAVAL
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 1:12 SARELLA SOCIETY BEHIND BANK OF BARODA
Mailing Address - Street 2:ST XAVIERS COLLEGE CORNER, NAVRANGPURA
Mailing Address - City:AHMEDABAD
Mailing Address - State:GUJARAT
Mailing Address - Zip Code:380009
Mailing Address - Country:IN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:39 W 38TH ST RM 3W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-5531
Practice Address - Country:US
Practice Address - Phone:212-386-7816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051217-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist