Provider Demographics
NPI:1851555965
Name:TAKADA, YOHEI (DPT)
Entity Type:Individual
Prefix:
First Name:YOHEI
Middle Name:
Last Name:TAKADA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6860 108TH ST
Mailing Address - Street 2:APT 2G
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2902
Mailing Address - Country:US
Mailing Address - Phone:646-512-1827
Mailing Address - Fax:
Practice Address - Street 1:6860 108TH ST
Practice Address - Street 2:APT 2G
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-2902
Practice Address - Country:US
Practice Address - Phone:646-512-1827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist