Provider Demographics
NPI:1871521781
Name:DESAI, SHEETAL (DPT)
Entity type:Individual
Prefix:DR
First Name:SHEETAL
Middle Name:
Last Name:DESAI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 ANDREW AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3425
Mailing Address - Country:US
Mailing Address - Phone:516-567-6312
Mailing Address - Fax:516-283-0258
Practice Address - Street 1:3 SCHOOL ST STE 204
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2548
Practice Address - Country:US
Practice Address - Phone:516-567-6312
Practice Address - Fax:516-283-0258
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0148122251G0304X, 2251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY014812OtherLICENSE NUMBER
NY2923164Medicaid
NY2923164Medicaid
NY2923164Medicaid