Healthcare Provider Details

I. General information

NPI: 1093158834
Provider Name (Legal Business Name): MANSI VAKIL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2013
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 JUNIPER RD
SCARSDALE NY
10583-1216
US

IV. Provider business mailing address

160 JUNIPER RD
SCARSDALE NY
10583-1216
US

V. Phone/Fax

Practice location:
  • Phone: 201-993-6818
  • Fax:
Mailing address:
  • Phone: 201-993-6818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number034909
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: