Provider Demographics
NPI:1982646253
Name:PADDU, NALINI U (MD)
Entity Type:Individual
Prefix:
First Name:NALINI
Middle Name:U
Last Name:PADDU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4902 QUEENS BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-4445
Mailing Address - Country:US
Mailing Address - Phone:718-784-4502
Mailing Address - Fax:
Practice Address - Street 1:4902 QUEENS BLVD
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-4444
Practice Address - Country:US
Practice Address - Phone:718-784-4502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1588872081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA61767Medicare UPIN