Provider Demographics
NPI:1649264516
Name:KUNDAN, RAMCHANDR SINGH (PT)
Entity type:Individual
Prefix:
First Name:RAMCHANDR
Middle Name:SINGH
Last Name:KUNDAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109-46 VAN WYCK EXPRESSWAY
Mailing Address - Street 2:SOUTH OZONE PARK
Mailing Address - City:QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11420-1814
Mailing Address - Country:US
Mailing Address - Phone:718-323-2933
Mailing Address - Fax:718-323-2931
Practice Address - Street 1:10946 VANWYCK EXPRESSWAY
Practice Address - Street 2:#1
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11420-1814
Practice Address - Country:US
Practice Address - Phone:718-323-2933
Practice Address - Fax:718-323-2931
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-07
Last Update Date:2007-07-09
Deactivation Date:2006-03-24
Deactivation Code:
Reactivation Date:2006-03-30
Provider Licenses
StateLicense IDTaxonomies
NY022033-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02661856Medicaid
NY02661856Medicaid