MEDICARE: RAJESWARI MALLAVARAPU PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	055843	NY

General Provider Information

NPI Number	:	1871424143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAJESWARI MALLAVARAPU PT

Provider Business Mailing Address
First Line	:	1184 MYRTLE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11221-7768
Country	:	US
Telephone Number	:	718-715-4871
Fax Number	:	347-503-4090

Provider Business Practice Location Address
First Line	:	1184 MYRTLE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11221-7768
Country	:	US
Telephone Number	:	347-915-6575
Fax Number	:	347-503-4090

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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