Basic Information
| Provider Information | |||||||||
| NPI: | 1093954265 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KHALE | ||||||||
| FirstName: | RADHIKA | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 337 RICHARD AVE APT DD3 | ||||||||
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| City: | HICKSVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 118011211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6072222623 | ||||||||
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| Practice Location | |||||||||
| Address1: | 189 WHEATLEY RD | ||||||||
| Address2: | |||||||||
| City: | GLEN HEAD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115452641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166261000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/11/2009 | ||||||||
| LastUpdateDate: | 08/17/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XP0200X | 013452 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics |
No ID Information.