Healthcare Provider Details

I. General information

NPI: 1245134360
Provider Name (Legal Business Name): MALVIKA RAWAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 BEACH 64TH ST
ARVERNE NY
11692-1423
US

IV. Provider business mailing address

16 FOSTER AVE
VALLEY STREAM NY
11580-2932
US

V. Phone/Fax

Practice location:
  • Phone: 646-737-4728
  • Fax: 332-316-6822
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: