Provider Demographics
NPI:1740432897
Name:PARDINI, ADA J (MHS, OTR/L)
Entity Type:Individual
Prefix:
First Name:ADA
Middle Name:J
Last Name:PARDINI
Suffix:
Gender:F
Credentials:MHS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:BURLINGHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12722-0008
Mailing Address - Country:US
Mailing Address - Phone:845-283-5531
Mailing Address - Fax:
Practice Address - Street 1:18 HAMILTON RD
Practice Address - Street 2:
Practice Address - City:BURLINGHAM
Practice Address - State:NY
Practice Address - Zip Code:12722
Practice Address - Country:US
Practice Address - Phone:845-283-5531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0076591171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor