Provider Demographics
NPI:1932353620
Name:SHIRODKAR, ZUBIN MATHEW (OTR/L)
Entity type:Individual
Prefix:MR
First Name:ZUBIN
Middle Name:MATHEW
Last Name:SHIRODKAR
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 AUDREY AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-3514
Mailing Address - Country:US
Mailing Address - Phone:516-935-4805
Mailing Address - Fax:
Practice Address - Street 1:59 AUDREY AVE
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-3514
Practice Address - Country:US
Practice Address - Phone:516-935-4805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-09
Last Update Date:2008-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007970-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics