Provider Demographics
NPI:1265231955
Name:CHITRODA, KRISHNA NARESH (PT)
Entity type:Individual
Prefix:
First Name:KRISHNA
Middle Name:NARESH
Last Name:CHITRODA
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 E 86TH ST FRNT 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2113
Mailing Address - Country:US
Mailing Address - Phone:212-831-3315
Mailing Address - Fax:
Practice Address - Street 1:157 E 86TH ST FRNT 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2113
Practice Address - Country:US
Practice Address - Phone:212-831-3315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053010225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist