Individual provider · NPI-1

Dr. Brindha Agilan, DPT

Physical Therapist · Forest Hills, NY

NPI number1689032955
StatusActive
Last updated in NPPESAug 3, 2020

Details

NPI
1689032955
Entity type
Individual (NPI-1)
Name
Dr. Brindha Agilan
Credential
DPT
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 2, 2016
Certification date
Aug 3, 2020
Last updated
Aug 3, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist039459NYYes
225100000X Physical Therapist2305210000VA

Practice location

10460 Queens Blvd
4y
Forest Hills, NY 11375-7318

Phone 909-800-3930

Mailing address

10460 Queens Blvd
4y
Forest Hills, NY 11375-7318

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