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General NPI Number Information
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NPI Number | 1629726054
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Entity Type | Individual
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Provider Name | GOLBARG HIEKALI DPT
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Gender | Female
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Dates
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Enumeration Date | 03/15/2022
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 435 W 31ST ST APT 10J
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City | NEW YORK
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State | NY
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Zip | 10001-4634
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Country | US
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Telephone | 310-753-2818
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Fax |
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Provider Business Mailing Address
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Address Line | 15565 AQUA VERDE DR
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City | LOS ANGELES
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State | CA
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Zip | 90077-1503
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Country | US
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Telephone | 310-753-2818
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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 | 048198
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License Number State | NY
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