Healthcare Provider Details

I. General information

NPI: 1811434178
Provider Name (Legal Business Name): SAILI MULGAONKAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2017
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3060 WALDORF MARKET PL
WALDORF MD
20603-4871
US

IV. Provider business mailing address

301 LENNON LN STE 202
WALNUT CREEK CA
94598-2433
US

V. Phone/Fax

Practice location:
  • Phone: 301-719-1146
  • Fax:
Mailing address:
  • Phone: 925-934-6373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number292660
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number25814
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: