Healthcare Provider Details

I. General information

NPI: 1417879149
Provider Name (Legal Business Name): HETAL NAIK PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HETAL GAJRE

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7506 LIBERTY AVE
OZONE PARK NY
11417-1034
US

IV. Provider business mailing address

8210 255TH ST
GLEN OAKS NY
11004-1411
US

V. Phone/Fax

Practice location:
  • Phone: 516-528-3909
  • Fax: 516-746-1039
Mailing address:
  • Phone: 917-283-1336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number036276
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: