Individual
CHANDNI THAKKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2710 LONG BEACH RD, OCEANSIDE, NY 11572-2255
(516) 558-7858
Mailing address
2710 LONG BEACH RD, OCEANSIDE, NY 11572-2255
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
016101-1
NY
Other
Enumeration date
12/07/2012
Last updated
08/08/2013
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