Provider Demographics
NPI:1316552235
Name:KUKADE, ANUPAMA (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:MS
First Name:ANUPAMA
Middle Name:
Last Name:KUKADE
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 SIERRA CT
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-3050
Mailing Address - Country:US
Mailing Address - Phone:732-401-6970
Mailing Address - Fax:
Practice Address - Street 1:74 SIERRA CT
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-3050
Practice Address - Country:US
Practice Address - Phone:732-401-6970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009834-01225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation