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General NPI Number Information
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NPI Number | 1003734674
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Entity Type | Individual
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Provider Name | DEVANSHI SANJAY MODI PT
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Gender | Female
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Dates
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Enumeration Date | 07/09/2026
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Last Update Date | 07/09/2026
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Provider Practice Location Address
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Address Line | 306 NASSAU BLVD
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City | GARDEN CITY
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State | NY
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Zip | 11530-5314
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Country | US
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Telephone | 516-208-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 20 RIVER CT APT 610
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City | JERSEY CITY
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State | NJ
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Zip | 07310-2204
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Country | US
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Telephone | 951-772-6772
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 051956
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License Number State | NY
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