Provider Demographics
NPI:1972668432
Name:VALAYADUM, RAJESHREE
Entity Type:Individual
Prefix:MISS
First Name:RAJESHREE
Middle Name:
Last Name:VALAYADUM
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:RAJESHREE
Other - Middle Name:
Other - Last Name:VALAYADUM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OT
Mailing Address - Street 1:3505 87TH ST
Mailing Address - Street 2:#5B
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-5648
Mailing Address - Country:US
Mailing Address - Phone:718-478-7568
Mailing Address - Fax:
Practice Address - Street 1:825 W END AVE
Practice Address - Street 2:#1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-5349
Practice Address - Country:US
Practice Address - Phone:212-866-0666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009317225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist