1174813034 NPI number — MR. HERSH MEERAM MAUSKAR B. TH. O ; OTR/L

Table of content: MR. HERSH MEERAM MAUSKAR B. TH. O ; OTR/L (NPI 1174813034)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174813034 NPI number — MR. HERSH MEERAM MAUSKAR B. TH. O ; OTR/L

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAUSKAR
Provider First Name:
HERSH
Provider Middle Name:
MEERAM
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
B. TH. O ; OTR/L
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MAUSKAR
Provider Other First Name:
HARSHAVARDHAN
Provider Other Middle Name:
RAMCHANDRA
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
B.TH. O ; OTR/L
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1174813034
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/29/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7579 GENESTA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63123-2800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-242-7643
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1587 SILHOUETTE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLERMONT
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34711-2757
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-242-7643
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/12/2011

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: 225X00000X , with the licence number:  OT7190 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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