Provider Demographics
NPI:1417388778
Name:KARDACHI, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:KARDACHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 E 22ND ST APT 3D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5726
Mailing Address - Country:US
Mailing Address - Phone:212-453-0036
Mailing Address - Fax:212-453-0037
Practice Address - Street 1:248 W 35TH ST
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2505
Practice Address - Country:US
Practice Address - Phone:212-453-0036
Practice Address - Fax:212-453-0037
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006835225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist