Provider Demographics
NPI:1164573218
Name:VALLURUPALLI, BHARAT K (OTR/L, CHT)
Entity Type:Individual
Prefix:MR
First Name:BHARAT
Middle Name:K
Last Name:VALLURUPALLI
Suffix:
Gender:M
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 MAPLE AVE W
Mailing Address - Street 2:SUITE 405
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-5677
Mailing Address - Country:US
Mailing Address - Phone:703-242-4263
Mailing Address - Fax:855-802-9786
Practice Address - Street 1:226 MAPLE AVE W
Practice Address - Street 2:SUITE 405
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-5677
Practice Address - Country:US
Practice Address - Phone:703-242-4263
Practice Address - Fax:855-802-9786
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119003801225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
175572ZF9UMedicare PIN