1417270869 NPI number — VIKRAM JHANJI PT

Table of content: VIKRAM JHANJI PT (NPI 1417270869)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417270869 NPI number — VIKRAM JHANJI PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JHANJI
Provider First Name:
VIKRAM
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417270869
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/12/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1450 CORAL BAY DR
Provider Second Line Business Mailing Address:
APT L
Provider Business Mailing Address City Name:
GREENWOOD
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46142-5173
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-576-5184
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9505 E 59TH ST
Provider Second Line Business Practice Location Address:
SUITE B1
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46216-1025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-542-7680
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/12/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  05010071A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X , with the licence number: 5501014651 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)