Provider Demographics
NPI:1245483957
Name:UDAY-CADIZ, KRISTINE MAE ROXAS (RPT)
Entity type:Individual
Prefix:
First Name:KRISTINE MAE
Middle Name:ROXAS
Last Name:UDAY-CADIZ
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8531 LEFFERTS BLVD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-3003
Mailing Address - Country:US
Mailing Address - Phone:347-820-4171
Mailing Address - Fax:
Practice Address - Street 1:42 WOLDEN RD
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-5302
Practice Address - Country:US
Practice Address - Phone:347-820-4171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-25
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028550225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist