Provider Demographics
NPI:1891337739
Name:GODHANI, MADHURIBEN
Entity Type:Individual
Prefix:
First Name:MADHURIBEN
Middle Name:
Last Name:GODHANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MADHURIBEN
Other - Middle Name:
Other - Last Name:CHAPADIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3909 STEVENSON BLVD APT 707
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2305
Mailing Address - Country:US
Mailing Address - Phone:510-944-8300
Mailing Address - Fax:
Practice Address - Street 1:3909 STEVENSON BLVD APT 707
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2305
Practice Address - Country:US
Practice Address - Phone:510-944-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-11
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant