Provider Demographics
NPI:1740264167
Name:BIKA, SHRADDHA ATODARIA (PT)
Entity type:Individual
Prefix:MS
First Name:SHRADDHA
Middle Name:ATODARIA
Last Name:BIKA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17081 88TH AVE N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-1412
Mailing Address - Country:US
Mailing Address - Phone:845-270-1350
Mailing Address - Fax:
Practice Address - Street 1:17081 88TH AVE N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55311-1412
Practice Address - Country:US
Practice Address - Phone:845-270-1350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0211731225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist