Provider Demographics
NPI:1508369265
Name:DHAMANE, KULBHUSHAN HIMMAT (BPTH, MPT, DPT)
Entity Type:Individual
Prefix:
First Name:KULBHUSHAN
Middle Name:HIMMAT
Last Name:DHAMANE
Suffix:
Gender:M
Credentials:BPTH, MPT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 CONKLIN ST APT 6
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-3740
Mailing Address - Country:US
Mailing Address - Phone:929-258-8571
Mailing Address - Fax:
Practice Address - Street 1:60 MERRICK AVE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1578
Practice Address - Country:US
Practice Address - Phone:516-222-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2021-06-08
Deactivation Date:2019-07-31
Deactivation Code:
Reactivation Date:2021-06-08
Provider Licenses
StateLicense IDTaxonomies
NY035890225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist