Provider Demographics
NPI:1902269277
Name:JAVAID, WARDA (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:WARDA
Middle Name:
Last Name:JAVAID
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2524 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-1502
Mailing Address - Country:US
Mailing Address - Phone:631-428-0334
Mailing Address - Fax:
Practice Address - Street 1:223 WALT WHITMAN RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-4118
Practice Address - Country:US
Practice Address - Phone:631-428-0334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-03
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036773225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist