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General NPI Number Information
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NPI Number | 1518518281
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Entity Type | Individual
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Provider Name | ELIANA FAYE NUDELL PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/24/2019
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Last Update Date | 03/30/2022
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Provider Practice Location Address
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Address Line | 6325 TOPANGA CANYON BLVD STE 100
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-2005
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Country | US
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Telephone | 818-340-8858
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Fax |
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Provider Business Mailing Address
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Address Line | 6140 CHESEBRO RD
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City | AGOURA HILLS
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State | CA
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Zip | 91301-1834
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Country | US
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Telephone | 818-264-5719
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT297288
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License Number State | CA
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