Provider Demographics
NPI:1285519611
Name:AMIN, NIYATI PRAKASHKUMAR
Entity type:Individual
Prefix:
First Name:NIYATI
Middle Name:PRAKASHKUMAR
Last Name:AMIN
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 1:835 GARDENBROOK CIR APT J
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-4675
Mailing Address - Country:US
Mailing Address - Phone:224-201-3557
Mailing Address - Fax:
Practice Address - Street 1:3202 BAINBRIDGE AVE APT D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-3947
Practice Address - Country:US
Practice Address - Phone:718-881-9525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053977225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty