Provider Demographics
NPI:1497460356
Name:GANGRADE, NAVIKA (PHD, RD)
Entity Type:Individual
Prefix:DR
First Name:NAVIKA
Middle Name:
Last Name:GANGRADE
Suffix:
Gender:F
Credentials:PHD, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 UNION ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-1386
Mailing Address - Country:US
Mailing Address - Phone:302-690-8790
Mailing Address - Fax:
Practice Address - Street 1:808 UNION ST STE 3A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-1386
Practice Address - Country:US
Practice Address - Phone:302-690-8790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered