Provider Demographics
NPI:1437355294
Name:DESHPANDE, MADHAVI VIJAY (OTR)
Entity Type:Individual
Prefix:
First Name:MADHAVI
Middle Name:VIJAY
Last Name:DESHPANDE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 RAMONFORD CT
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-5067
Mailing Address - Country:US
Mailing Address - Phone:614-880-9004
Mailing Address - Fax:
Practice Address - Street 1:165 HIGHBLUFFS BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-1484
Practice Address - Country:US
Practice Address - Phone:614-846-6076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT6381225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist