Provider Demographics
NPI:1053550475
Name:VATHANI REHAB INC
Entity type:Organization
Organization Name:VATHANI REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHANDRA
Authorized Official - Middle Name:V
Authorized Official - Last Name:SADANANTHAM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:845-569-1277
Mailing Address - Street 1:5 HAMPSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10992-1268
Mailing Address - Country:US
Mailing Address - Phone:845-569-1277
Mailing Address - Fax:
Practice Address - Street 1:815 BLOOMING GROVE TPKE
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-8135
Practice Address - Country:US
Practice Address - Phone:845-569-1277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019638225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ05441Medicare PIN