Provider Demographics
NPI:1578840435
Name:KAUSHIK, NISHITKUMAR ANILKUMAR (PT)
Entity Type:Individual
Prefix:MR
First Name:NISHITKUMAR
Middle Name:ANILKUMAR
Last Name:KAUSHIK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2752 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4706
Mailing Address - Country:US
Mailing Address - Phone:718-769-9001
Mailing Address - Fax:718-769-9002
Practice Address - Street 1:2752 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4706
Practice Address - Country:US
Practice Address - Phone:718-769-9001
Practice Address - Fax:718-769-9002
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033777225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist