Provider Demographics
NPI:1861061848
Name:BHALIYA, NILAM
Entity type:Individual
Prefix:MISS
First Name:NILAM
Middle Name:
Last Name:BHALIYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3944 59TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-4370
Mailing Address - Country:US
Mailing Address - Phone:347-339-8842
Mailing Address - Fax:
Practice Address - Street 1:244 W 54TH ST STE 1002
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5597
Practice Address - Country:US
Practice Address - Phone:212-262-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047274225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist