Provider Demographics
NPI:1053165779
Name:HUNDAL, RAJVIR (PT)
Entity type:Individual
Prefix:
First Name:RAJVIR
Middle Name:
Last Name:HUNDAL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 OLD COUNTRY RD STE 106
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4932
Mailing Address - Country:US
Mailing Address - Phone:516-719-0719
Mailing Address - Fax:516-224-9220
Practice Address - Street 1:700 OLD COUNTRY RD STE 106
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4932
Practice Address - Country:US
Practice Address - Phone:516-719-0719
Practice Address - Fax:516-224-9220
Is Sole Proprietor?:No
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034296-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist