Provider Demographics
NPI:1457067290
Name:LOKHANDWALA, MARYA
Entity Type:Individual
Prefix:
First Name:MARYA
Middle Name:
Last Name:LOKHANDWALA
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 1:522 AMHERST ST STE 23
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-1019
Mailing Address - Country:US
Mailing Address - Phone:603-880-0448
Mailing Address - Fax:
Practice Address - Street 1:254 LOWELL ST
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-4600
Practice Address - Country:US
Practice Address - Phone:603-484-4070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA25965225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA25965OtherALLIED HEALTH PROFESSIONALS