Provider Demographics
NPI:1962041152
Name:GADINGAN, CHILE
Entity Type:Individual
Prefix:
First Name:CHILE
Middle Name:
Last Name:GADINGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 67TH ST APT C4
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-4930
Mailing Address - Country:US
Mailing Address - Phone:929-271-7130
Mailing Address - Fax:
Practice Address - Street 1:55 NORTHERN BLVD STE 103
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4058
Practice Address - Country:US
Practice Address - Phone:929-271-7130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-05
Last Update Date:2020-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist