Healthcare Provider Details

I. General information

NPI: 1962357004
Provider Name (Legal Business Name): YASHVI GOGRI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 E MAIN ST
STAMFORD CT
06902-3832
US

IV. Provider business mailing address

55 BROOK RUN LN
STAMFORD CT
06905-3002
US

V. Phone/Fax

Practice location:
  • Phone: 203-443-8778
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15530
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: