Healthcare Provider Details

I. General information

NPI: 1053550475
Provider Name (Legal Business Name): VATHANI REHAB INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2009
Last Update Date: 02/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 BLOOMING GROVE TPKE
NEW WINDSOR NY
12553-8135
US

IV. Provider business mailing address

5 HAMPSHIRE DR
WASHINGTONVILLE NY
10992-1268
US

V. Phone/Fax

Practice location:
  • Phone: 845-569-1277
  • Fax:
Mailing address:
  • Phone: 845-569-1277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number019638
License Number StateNY

VIII. Authorized Official

Name: MS. CHANDRA V SADANANTHAM
Title or Position: PHYSICAL THERAPIST
Credential: PT
Phone: 845-569-1277