Provider Demographics
NPI:1174564660
Name:DAS, PRIYA MALINI (MSPT,MSED)
Entity type:Individual
Prefix:MISS
First Name:PRIYA
Middle Name:MALINI
Last Name:DAS
Suffix:
Gender:F
Credentials:MSPT,MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2369 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-3353
Mailing Address - Country:US
Mailing Address - Phone:516-238-9879
Mailing Address - Fax:516-781-6316
Practice Address - Street 1:5435 BEAVERKILL RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2359
Practice Address - Country:US
Practice Address - Phone:410-740-0883
Practice Address - Fax:410-740-9970
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022145174400000X
MD20481225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist