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General NPI Number Information
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NPI Number | 1144801655
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Entity Type | Individual
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Provider Name | DEEPALI RAHUL GADE PT
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Gender | Female
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Dates
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Enumeration Date | 04/16/2021
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Last Update Date | 03/31/2023
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Provider Practice Location Address
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Address Line | 31 NEW DORP LN
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2351
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Country | US
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Telephone | 718-979-4466
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Fax |
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Provider Business Mailing Address
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Address Line | 55 ARLO RD APT 2B
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City | STATEN ISLAND
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State | NY
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Zip | 10301-4704
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Country | US
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Telephone | 551-214-6575
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 45555
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License Number State | NY
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