Basic Information
| Provider Information | |||||||||
| NPI: | 1053548958 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAMATH | ||||||||
| FirstName: | SUCHITRA | ||||||||
| MiddleName: | RAMDAS | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | DPT,PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 AXINN AVE | ||||||||
| Address2: | |||||||||
| City: | GARDEN CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115302139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6466802888 | ||||||||
| FaxNumber: | 5165425556 | ||||||||
| Practice Location | |||||||||
| Address1: | 195 MONTAGUE ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112013628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184228000 | ||||||||
| FaxNumber: | 7184228265 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2009 | ||||||||
| LastUpdateDate: | 04/29/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 027118 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.