Provider Demographics
NPI:1265681225
Name:APTE, KETAKI VAIBHAV
Entity Type:Individual
Prefix:MS
First Name:KETAKI
Middle Name:VAIBHAV
Last Name:APTE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KETAKI
Other - Middle Name:MADHAV
Other - Last Name:RANADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:44962 PAINE DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-2557
Mailing Address - Country:US
Mailing Address - Phone:517-231-6019
Mailing Address - Fax:
Practice Address - Street 1:40000 8 MILE RD
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-2134
Practice Address - Country:US
Practice Address - Phone:248-380-6222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05009161A225100000X
MI5501012575225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist