Provider Demographics
NPI:1811792914
Name:SUBNANI, NIKITA N
Entity type:Individual
Prefix:
First Name:NIKITA
Middle Name:N
Last Name:SUBNANI
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 1:633 W 5TH ST OFC 2876B
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90071-2005
Mailing Address - Country:US
Mailing Address - Phone:512-377-6318
Mailing Address - Fax:
Practice Address - Street 1:935 CALEDONIA ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-1129
Practice Address - Country:US
Practice Address - Phone:267-222-2539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist