Provider Demographics
NPI:1356686588
Name:ACHUTHA-FALVO, KAVITHA JOTHI (DPT)
Entity Type:Individual
Prefix:
First Name:KAVITHA
Middle Name:JOTHI
Last Name:ACHUTHA-FALVO
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 1:1377 MOTOR PKWY
Mailing Address - Street 2:STE 307
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-5258
Mailing Address - Country:US
Mailing Address - Phone:908-879-0644
Mailing Address - Fax:
Practice Address - Street 1:9000 E NICHOLS AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3475
Practice Address - Country:US
Practice Address - Phone:866-996-1735
Practice Address - Fax:866-300-4166
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-28
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA006546002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic