Healthcare Provider Details

I. General information

NPI: 1457213274
Provider Name (Legal Business Name): SNEHA RADHAKRISHNAN NAIR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 WASHINGTON BLVD
JERSEY CITY NJ
07310-1400
US

IV. Provider business mailing address

610 WASHINGTON BLVD
JERSEY CITY NJ
07310-1400
US

V. Phone/Fax

Practice location:
  • Phone: 212-227-3233
  • Fax: 866-549-5687
Mailing address:
  • Phone: 212-227-3233
  • Fax: 866-549-5687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02280100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: