Provider Demographics
NPI:1033529516
Name:GOENKA, SHIKHA
Entity Type:Individual
Prefix:
First Name:SHIKHA
Middle Name:
Last Name:GOENKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3096 12TH ST
Mailing Address - Street 2:APT 4
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-4036
Mailing Address - Country:US
Mailing Address - Phone:207-735-7051
Mailing Address - Fax:
Practice Address - Street 1:2 RECTOR ST
Practice Address - Street 2:SUITE- 1303
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-1819
Practice Address - Country:US
Practice Address - Phone:212-374-0181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037178225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist