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General NPI Number Information
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NPI Number | 1073137154
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Entity Type | Individual
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Provider Name | SAILI KANTAK
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Gender | Female
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Dates
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Enumeration Date | 06/03/2020
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Last Update Date | 03/31/2022
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Provider Practice Location Address
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Address Line | 2550 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-6611
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Country | US
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Telephone | 718-761-0017
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Fax |
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Provider Business Mailing Address
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Address Line | 204 10TH ST APT 227
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City | JERSEY CITY
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State | NJ
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Zip | 07302-7412
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Country | US
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Telephone | 909-602-7465
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 045209
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License Number State | NY
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