Provider Demographics
NPI:1326162355
Name:NALLADARU, DILNAZ H (PT)
Entity Type:Individual
Prefix:MISS
First Name:DILNAZ
Middle Name:H
Last Name:NALLADARU
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:266 HARRISTOWN RD STE 304
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-3321
Mailing Address - Country:US
Mailing Address - Phone:201-857-0527
Mailing Address - Fax:201-689-4588
Practice Address - Street 1:188 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3318
Practice Address - Country:US
Practice Address - Phone:800-750-8616
Practice Address - Fax:845-362-8474
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027431171W00000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA40000275Medicare PIN