Provider Demographics
NPI:1083046163
Name:SAMINATH, DHANDAI
Entity Type:Individual
Prefix:MS
First Name:DHANDAI
Middle Name:
Last Name:SAMINATH
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 1:10127 131ST ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-2346
Mailing Address - Country:US
Mailing Address - Phone:347-771-6878
Mailing Address - Fax:
Practice Address - Street 1:10127 131ST ST
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-2346
Practice Address - Country:US
Practice Address - Phone:347-771-6878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist