MEDICARE: LATIKA THAKUR PHYSICAL THERAPIST

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	034347	NY
2	2251C2600X	Cardiopulmonary Physical Therapist	034347	NY
3	2251E1200X	Ergonomics Physical Therapist	034347	NY
4	2251E1300X	Clinical Electrophysiology Physical Therapist	034347	NY
5	2251G0304X	Geriatric Physical Therapist	034347	NY
6	2251H1200X	Hand Physical Therapist	034347	NY
7	2251H1300X	Human Factors Physical Therapist	034347	NY
8	2251N0400X	Neurology Physical Therapist	034347	NY
9	2251P0200X	Pediatric Physical Therapist	034347	NY
10	2251S0007X	Sports Physical Therapist	034347	NY
11	2251X0800X	Orthopedic Physical Therapist	034347	NY

General Provider Information

NPI Number	:	1821360678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATIKA THAKUR PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	5806 16TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-2111
Country	:	US
Telephone Number	:	718-232-2300
Fax Number	:	718-236-3449

Provider Business Practice Location Address
First Line	:	5806 16TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-2111
Country	:	US
Telephone Number	:	718-232-2300
Fax Number	:	718-236-3449

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

Provider Enumeration Date	:	02/08/2012
Last Update Date	:	02/08/2012

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