Provider Demographics
NPI:1821634676
Name:PHADKE, APOORVA (PT)
Entity Type:Individual
Prefix:
First Name:APOORVA
Middle Name:
Last Name:PHADKE
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:A-4 SHIVTIRTH SOC. PARAMHANS NAGAR LANE-2
Mailing Address - Street 2:PAUD ROAD. KOTHRUD.
Mailing Address - City:PUNE
Mailing Address - State:MAHARASHTRA
Mailing Address - Zip Code:411038
Mailing Address - Country:IN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:638 MARSALA CT
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6950
Practice Address - Country:US
Practice Address - Phone:510-738-8384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-26
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0443332251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD336305801Medicaid