1326264375 NPI number — MS. DELALI ABLA GOKA PT, DPT

Table of content: MS. DELALI ABLA GOKA PT, DPT (NPI 1326264375)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326264375 NPI number — MS. DELALI ABLA GOKA PT, DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOKA
Provider First Name:
DELALI
Provider Middle Name:
ABLA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326264375
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/22/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 LANDMARK SQ
Provider Second Line Business Mailing Address:
#410
Provider Business Mailing Address City Name:
PORT CHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10573-3348
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-939-0050
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
333 MAMARONECK AVE
Provider Second Line Business Practice Location Address:
#331
Provider Business Practice Location Address City Name:
WHITE PLAINS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10605-1440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-458-2249
Provider Business Practice Location Address Fax Number:
914-885-1072
Provider Enumeration Date:
04/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  263191 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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