Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 038803-1 | NY |
Y | 225100000X | Physical Therapist | 1296743 | TX |
NPI | 1003296773 |
---|---|
Provider Name | Aaditya Vaidya |
First Address | Houston, TX 77089-2647 |
Second Address | Richmond Hill, NY 11418-2014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2015 |
Last Update Date | 08/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
038803-1 | LICENSE NUMBER (01) | NY |
1296743 | LICENSE NUMBER (01) | TX |