Provider Demographics
NPI:1013374305
Name:SETHI, PRERNA (MS)
Entity Type:Individual
Prefix:
First Name:PRERNA
Middle Name:
Last Name:SETHI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26440 HOOVER
Mailing Address - Street 2:SUITE A
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48089
Mailing Address - Country:US
Mailing Address - Phone:586-756-7500
Mailing Address - Fax:586-486-1700
Practice Address - Street 1:18200 E TENMILE ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021
Practice Address - Country:US
Practice Address - Phone:586-771-7500
Practice Address - Fax:586-486-1700
Is Sole Proprietor?:No
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017498225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501017498OtherPHYSICAL THERAPIST