Provider Demographics
NPI:1427022391
Name:ARADHYA, PADMAJA (MD)
Entity Type:Individual
Prefix:DR
First Name:PADMAJA
Middle Name:
Last Name:ARADHYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 N BROADWAY STE 2
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-2303
Mailing Address - Country:US
Mailing Address - Phone:516-520-5507
Mailing Address - Fax:516-520-5493
Practice Address - Street 1:924 N BROADWAY # 2
Practice Address - Street 2:ISLAND NEUROLOGICAL THERAPY, PC
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-2303
Practice Address - Country:US
Practice Address - Phone:516-520-5507
Practice Address - Fax:516-520-5493
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1985772084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02208148Medicaid
NY02208148Medicaid
H32114Medicare UPIN