Provider Demographics
NPI:1164212494
Name:JODHANI, NIDHI VALLABHBHAI
Entity type:Individual
Prefix:
First Name:NIDHI
Middle Name:VALLABHBHAI
Last Name:JODHANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 PATERSON ST APT 2
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-4370
Mailing Address - Country:US
Mailing Address - Phone:551-697-3343
Mailing Address - Fax:
Practice Address - Street 1:13630 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3865
Practice Address - Country:US
Practice Address - Phone:718-540-8099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP134814225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist