Provider Demographics
NPI:1073320420
Name:NAIK, BINDI KUNAL
Entity type:Individual
Prefix:
First Name:BINDI
Middle Name:KUNAL
Last Name:NAIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BINDI
Other - Middle Name:KAMLESHBHAI
Other - Last Name:DESAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19 NELSON AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-4584
Mailing Address - Country:US
Mailing Address - Phone:904-430-5612
Mailing Address - Fax:
Practice Address - Street 1:3719 108TH ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-4176
Practice Address - Country:US
Practice Address - Phone:347-695-6932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
053408225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist