Provider Demographics
NPI:1316284615
Name:MAVADIA, PURNIMA (RRT, RPFT, NPS,RPSGT)
Entity type:Individual
Prefix:MS
First Name:PURNIMA
Middle Name:
Last Name:MAVADIA
Suffix:
Gender:F
Credentials:RRT, RPFT, NPS,RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 STELTON RD
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-2636
Mailing Address - Country:US
Mailing Address - Phone:732-688-7842
Mailing Address - Fax:
Practice Address - Street 1:138 STELTON RD
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-2636
Practice Address - Country:US
Practice Address - Phone:732-688-7842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ43ZA00305600227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered