Healthcare Provider Details

I. General information

NPI: 1225663842
Provider Name (Legal Business Name): SAVITRI RESAL LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2020
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1181 OLD COUNTRY ROAD SUITE #1
PLAINVIEW NY
11803
US

IV. Provider business mailing address

9338 SPRINGFIELD BLVD
QUEENS VILLAGE NY
11428
US

V. Phone/Fax

Practice location:
  • Phone: 917-545-6513
  • Fax: 516-822-9794
Mailing address:
  • Phone: 917-545-6513
  • Fax: 516-822-9794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number025273-1
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: