Provider Demographics
NPI:1396758959
Name:NILKANTH, REKHA (PT)
Entity type:Individual
Prefix:
First Name:REKHA
Middle Name:
Last Name:NILKANTH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 ANDOVER DR
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-3928
Mailing Address - Country:US
Mailing Address - Phone:213-747-0634
Mailing Address - Fax:213-741-9478
Practice Address - Street 1:1212 S FLOWER ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-2123
Practice Address - Country:US
Practice Address - Phone:213-747-0634
Practice Address - Fax:213-741-9478
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT16004225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist