Provider Demographics
NPI:1215812029
Name:BALADANIYA, RAMESHKUMAR
Entity type:Individual
Prefix:
First Name:RAMESHKUMAR
Middle Name:
Last Name:BALADANIYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 CHURCH ST UNIT 5
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-2437
Mailing Address - Country:US
Mailing Address - Phone:201-375-2336
Mailing Address - Fax:
Practice Address - Street 1:2932 WILKINSON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-4004
Practice Address - Country:US
Practice Address - Phone:718-904-0908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045867225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty