Basic Information
| Provider Information | |||||||||
| NPI: | 1700117058 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WADIA | ||||||||
| FirstName: | SALONI | ||||||||
| MiddleName: | MANISH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11818 UNION TPKE | ||||||||
| Address2: | 20 K AND A | ||||||||
| City: | KEW GARDENS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114151037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187025289 | ||||||||
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| Practice Location | |||||||||
| Address1: | 17810 WEXFORD TER | ||||||||
| Address2: | 1K | ||||||||
| City: | JAMAICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114323050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186581123 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2010 | ||||||||
| LastUpdateDate: | 02/12/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0015X | 254699 | NY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychosomatic Medicine |
No ID Information.