Provider Demographics
NPI:1124359104
Name:BATHEJA, ASHISH K (PT)
Entity Type:Individual
Prefix:
First Name:ASHISH
Middle Name:K
Last Name:BATHEJA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4551 POPPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-2043
Mailing Address - Country:US
Mailing Address - Phone:402-578-4642
Mailing Address - Fax:
Practice Address - Street 1:10730 PACIFIC ST STE 210
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4761
Practice Address - Country:US
Practice Address - Phone:402-578-4642
Practice Address - Fax:888-219-4316
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-15
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1881225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist