Individual
AJAY PADAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
833 NORTHERN BLVD STE 220, GREAT NECK, NY 11021-5339
(516) 622-7945
Mailing address
833 NORTHERN BLVD STE 220, GREAT NECK, NY 11021-5339
(516) 622-7945
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
317385
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053766642
NPI
—
Enumeration date
05/02/2016
Last updated
11/09/2022
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