Provider Demographics
NPI:1649409236
Name:THAKKER, URVI (DO)
Entity Type:Individual
Prefix:
First Name:URVI
Middle Name:
Last Name:THAKKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26617 E WILLISTON AVE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-1154
Mailing Address - Country:US
Mailing Address - Phone:201-838-5237
Mailing Address - Fax:515-417-8381
Practice Address - Street 1:26617 E WILLISTON AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-1154
Practice Address - Country:US
Practice Address - Phone:201-838-5237
Practice Address - Fax:515-417-8381
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY248165208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics