Individual
ANISHA JADAV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 OLD COUNTRY RD STE C103N, WESTBURY, NY 11590-5156
(516) 806-6969
Mailing address
18 W COURT DR, CENTEREACH, NY 11720-2328
(516) 491-7575
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
235Z00000X
Speech-Language Pathologist
Primary
032957-01
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/23/2022
Last updated
08/10/2023
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