Prashant Malhotra, PT

Individual provider Active NPI Physical Therapist · Ticonderoga, NY

NPI 1780845164 · NPPES record last updated Jun 19, 2008

Key facts

NPI
1780845164
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
030330 (NY)
Practice address
1019 Wicker St
Ticonderoga, NY 12883-1039
Phone
(518) 585-3810
Fax
(518) 585-3822
NPI assigned
Jun 19, 2008
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 030330 NY Yes

Addresses

Primary practice location

1019 Wicker St
Ticonderoga, NY 12883-1039

Mailing address

1019 Wicker St
Ticonderoga, NY 12883-1039
Phone (518) 585-3810

Other providers in Ticonderoga, NY

All providers in Ticonderoga, NY · Physical Therapist in New York

Sources for this page

Verify at the official NPI Registry.