Basic Information
Provider Information
NPI: 1780222620
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KADAKIA
FirstName: ASHNI
MiddleName:  
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Mailing Information
Address1: 576 BROADHOLLOW RD
Address2:  
City: MELVILLE
State: NY
PostalCode: 117475002
CountryCode: US
TelephoneNumber: 6313595859
FaxNumber: 6313960864
Practice Location
Address1: 8002 KEW GARDENS RD FL 4
Address2:  
City: KEW GARDENS
State: NY
PostalCode: 114153604
CountryCode: US
TelephoneNumber: 7182637500
FaxNumber: 7182637502
Other Information
ProviderEnumerationDate: 12/11/2019
LastUpdateDate: 12/11/2019
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode: F
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IsSoleProprietor: N
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NPICertificationDate: 12/11/2019

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X045145NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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