Provider Demographics
NPI:1528270592
Name:TADAK, PAUL FRANCIS (PT)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:FRANCIS
Last Name:TADAK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 NORTHRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3355
Mailing Address - Country:US
Mailing Address - Phone:614-286-4996
Mailing Address - Fax:
Practice Address - Street 1:690 LAKEVIEW PLAZA BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-4732
Practice Address - Country:US
Practice Address - Phone:614-802-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH010232174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist