Provider Demographics
NPI:1568596252
Name:DEY, SWETA (RPT)
Entity Type:Individual
Prefix:MRS
First Name:SWETA
Middle Name:
Last Name:DEY
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1890 AXTELL DR
Mailing Address - Street 2:#8
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4405
Mailing Address - Country:US
Mailing Address - Phone:248-470-6220
Mailing Address - Fax:
Practice Address - Street 1:1890 AXTELL DR
Practice Address - Street 2:#8
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4405
Practice Address - Country:US
Practice Address - Phone:248-470-6220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1037788225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP40780002Medicare PIN