Provider Demographics
NPI:1053984922
Name:WATERS, SATCHAL
Entity type:Individual
Prefix:DR
First Name:SATCHAL
Middle Name:
Last Name:WATERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845-2175
Mailing Address - Country:US
Mailing Address - Phone:607-739-1700
Mailing Address - Fax:
Practice Address - Street 1:1115 U ST NW STE 202
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-7875
Practice Address - Country:US
Practice Address - Phone:202-897-3991
Practice Address - Fax:202-888-8038
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048020225100000X
DCPT210002153225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist