MEDICARE: MS. DHRUVIKA GONDALIA PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT308395	CA

General Provider Information

NPI Number	:	1811590417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DHRUVIKA GONDALIA PT

Provider Business Mailing Address
First Line	:	45 BERRY HILL RD
Second Line	:
City	:	SYOSSET
State	:	NY
Zip	:	11791-2624
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1392 E PALOMAR ST STE 503
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91913-1895
Country	:	US
Telephone Number	:	619-482-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2020
Last Update Date	:	11/11/2025

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