Active NPI
Dipti Raval
- Physical Therapist
- Great Neck, NY
National Provider Identifier
1487928990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 034520-1
- Practice address
- 475 Northern Blvd
Suite 11
Great Neck, NY 11021-4819 - Phone
- (516) 829-0030
- NPI assigned
- Mar 1, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 034520-1 | NY | Primary |
Addresses
Primary practice location
475 Northern Blvd
Suite 11
Great Neck, NY 11021-4819
Mailing address
475 Northern Blvd
Suite 11
Great Neck, NY 11021-4819
Phone (516) 829-0030
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 034520 | NY | MD | Dentist |
| 034520-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384473600000",
"number": "1487928990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 NORTHERN BLVD",
"address_2": "SUITE 11",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110214819",
"telephone_number": "516-829-0030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 NORTHERN BLVD",
"address_2": "SUITE 11",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110214819",
"telephone_number": "516-829-0030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAVAL",
"first_name": "DIPTI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-01",
"last_updated": "2013-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "034520-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.