MEDICARE: MS. SHRADDHA ATODARIA BIKA PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	0211731	NY

General Provider Information

NPI Number	:	1740264167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHRADDHA ATODARIA BIKA PT

Provider Business Mailing Address
First Line	:	17081 88TH AVE N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-1412
Country	:	US
Telephone Number	:	845-270-1350
Fax Number	:

Provider Business Practice Location Address
First Line	:	17081 88TH AVE N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-1412
Country	:	US
Telephone Number	:	845-270-1350
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	06/28/2013

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