Provider Demographics
NPI:1346936598
Name:KAVACHERI SUBRAMANIAM, PADMAPRIYA (DPT)
Entity Type:Individual
Prefix:
First Name:PADMAPRIYA
Middle Name:
Last Name:KAVACHERI SUBRAMANIAM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 SOUTHERLY CT
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-5764
Mailing Address - Country:US
Mailing Address - Phone:804-709-9990
Mailing Address - Fax:
Practice Address - Street 1:2620A GASKINS RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23238-1402
Practice Address - Country:US
Practice Address - Phone:804-874-2476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049723225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist