Provider Demographics
NPI:1235375973
Name:PRAJAPATI, RAGHVENDRA (CPED)
Entity Type:Individual
Prefix:
First Name:RAGHVENDRA
Middle Name:
Last Name:PRAJAPATI
Suffix:
Gender:M
Credentials:CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 E 14TH ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-3200
Mailing Address - Country:US
Mailing Address - Phone:402-461-4931
Mailing Address - Fax:402-461-4932
Practice Address - Street 1:223 E 14TH ST
Practice Address - Street 2:SUITE 5
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-3200
Practice Address - Country:US
Practice Address - Phone:402-461-4931
Practice Address - Fax:402-461-4932
Is Sole Proprietor?:No
Enumeration Date:2008-12-31
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE2981OtherAMERICAN BOARD FOR CERTIFICATION IN PROSTHETICS & ORHTOTICS