Basic Information
Provider Information
NPI: 1609155779
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SEEMANGAL
FirstName: VARSHA
MiddleName: Y.
NamePrefix:  
NameSuffix:  
Credential: P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: PARASRAM
OtherFirstName: VARSHA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: P.T.
OtherLastNameType: 1
Mailing Information
Address1: 535 E 70TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100214823
CountryCode: US
TelephoneNumber: 6467146850
FaxNumber:  
Practice Location
Address1: 535 E 70TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100214823
CountryCode: US
TelephoneNumber: 6467146850
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/08/2011
LastUpdateDate: 04/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X034044NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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