Provider Demographics
NPI:1245421221
Name:GADRE, ANJALI ANIRUDDHA (PT)
Entity Type:Individual
Prefix:
First Name:ANJALI
Middle Name:ANIRUDDHA
Last Name:GADRE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:BHAGYASHREE
Other - Middle Name:VASANT
Other - Last Name:SAHASRABUDHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25420 KUYKENDAHL RD STE F600
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77375-3405
Mailing Address - Country:US
Mailing Address - Phone:832-610-5564
Mailing Address - Fax:
Practice Address - Street 1:2835 MIAMI VILLAGE DR
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-4916
Practice Address - Country:US
Practice Address - Phone:937-449-0796
Practice Address - Fax:937-262-7468
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021923225100000X
OHPT019135225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist