Provider Demographics
NPI:1518133107
Name:KAKARALA, BINDHU SREE (PT)
Entity Type:Individual
Prefix:MS
First Name:BINDHU
Middle Name:SREE
Last Name:KAKARALA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MERLE CT
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1123
Mailing Address - Country:US
Mailing Address - Phone:732-770-8684
Mailing Address - Fax:
Practice Address - Street 1:25 VICTORY BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-2905
Practice Address - Country:US
Practice Address - Phone:718-815-7246
Practice Address - Fax:718-815-7363
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-02
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist