Provider Demographics
NPI:1568765188
Name:SAXENA, ANSHU KUMAR (PT, MS MPT(NEURO))
Entity Type:Individual
Prefix:
First Name:ANSHU
Middle Name:KUMAR
Last Name:SAXENA
Suffix:
Gender:M
Credentials:PT, MS MPT(NEURO)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 NORMANDY DR
Mailing Address - Street 2:APT 3B
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-7602
Mailing Address - Country:US
Mailing Address - Phone:409-201-2115
Mailing Address - Fax:
Practice Address - Street 1:802 E US HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-7424
Practice Address - Country:US
Practice Address - Phone:219-872-3121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-21
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05009993A225100000X, 2251G0304X, 2251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology