Provider Demographics
NPI:1013179704
Name:TRIPATHI, ANJALI (OTR)
Entity Type:Individual
Prefix:
First Name:ANJALI
Middle Name:
Last Name:TRIPATHI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 DOGTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GOOCHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23063-2424
Mailing Address - Country:US
Mailing Address - Phone:804-556-4418
Mailing Address - Fax:804-556-4485
Practice Address - Street 1:2715 DOGTOWN RD
Practice Address - Street 2:
Practice Address - City:GOOCHLAND
Practice Address - State:VA
Practice Address - Zip Code:23063-2424
Practice Address - Country:US
Practice Address - Phone:804-556-4418
Practice Address - Fax:804-556-4485
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119004685225X00000X
IN31002668A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist