Provider Demographics
NPI:1346093762
Name:OBADINA, COMFORT (PT, DPT)
Entity Type:Individual
Prefix:
First Name:COMFORT
Middle Name:
Last Name:OBADINA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 EVERIT AVE
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1303
Mailing Address - Country:US
Mailing Address - Phone:347-731-9836
Mailing Address - Fax:
Practice Address - Street 1:30 EVERIT AVE
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1303
Practice Address - Country:US
Practice Address - Phone:347-731-9836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY03576301225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist