Provider Demographics
NPI:1912490079
Name:PRABHU, SNEHA PRADEEP (PT)
Entity Type:Individual
Prefix:
First Name:SNEHA
Middle Name:PRADEEP
Last Name:PRABHU
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 1:8 W 38TH ST RM 1201
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-0134
Mailing Address - Country:US
Mailing Address - Phone:212-421-6509
Mailing Address - Fax:212-679-4268
Practice Address - Street 1:8 W 38TH ST RM 1201
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-0134
Practice Address - Country:US
Practice Address - Phone:212-421-6509
Practice Address - Fax:212-679-4268
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038735225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist