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General NPI Number Information
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NPI Number | 1164808671
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Entity Type | Individual
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Provider Name | PAYAL ANTALA DPT
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Gender | Female
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Dates
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Enumeration Date | 08/06/2015
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 169 MADISON AVE STE 15501
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City | NEW YORK
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State | NY
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Zip | 10016-5101
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Country | US
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Telephone | 385-308-8034
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Fax |
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Provider Business Mailing Address
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Address Line | 169 MADISON AVE STE 15501
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City | NEW YORK
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State | NY
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Zip | 10016-5101
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Country | US
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Telephone | 385-308-8034
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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 | PT61188074
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 308189
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01780900
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT026727
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 054112
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License Number State | NY
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