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General NPI Number Information
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NPI Number | 1750105516
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Entity Type | Individual
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Provider Name | MANAVI ROMIT DALAL
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Gender | Female
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Dates
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Enumeration Date | 11/08/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 111 COLCHESTER AVE
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City | BURLINGTON
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State | VT
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Zip | 05401-1473
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Country | US
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Telephone | 802-847-2450
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Fax |
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Provider Business Mailing Address
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Address Line | 10707 WEEPING WILLOW LN
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City | BELTSVILLE
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State | MD
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Zip | 20705-3820
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Country | US
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Telephone | 412-214-2789
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 10357
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 072.0134516
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License Number State | VT
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