Provider Demographics
NPI:1437504305
Name:CHURI, HEEMA
Entity Type:Individual
Prefix:
First Name:HEEMA
Middle Name:
Last Name:CHURI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 MARYLAND RD STE 250
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1133
Mailing Address - Country:US
Mailing Address - Phone:215-481-5800
Mailing Address - Fax:215-481-5986
Practice Address - Street 1:2510 MARYLAND RD STE 250
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1133
Practice Address - Country:US
Practice Address - Phone:215-481-5800
Practice Address - Fax:215-481-5986
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC000654L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist