Provider Demographics
NPI:1235450016
Name:GADKARI, PRADNYA (PT,MPT)
Entity Type:Individual
Prefix:MRS
First Name:PRADNYA
Middle Name:
Last Name:GADKARI
Suffix:
Gender:F
Credentials:PT,MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2904 BRUCKNER BLVD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-2101
Mailing Address - Country:US
Mailing Address - Phone:347-582-2534
Mailing Address - Fax:347-582-2359
Practice Address - Street 1:1500 ASTOR AVE
Practice Address - Street 2:#1E
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5900
Practice Address - Country:US
Practice Address - Phone:347-843-7070
Practice Address - Fax:347-843-7063
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028649-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist