Provider Demographics
NPI:1659605798
Name:IYER, JANAKI BABU (PT)
Entity Type:Individual
Prefix:MISS
First Name:JANAKI
Middle Name:BABU
Last Name:IYER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3264 KAISER DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-4555
Mailing Address - Country:US
Mailing Address - Phone:443-535-3649
Mailing Address - Fax:
Practice Address - Street 1:4052 LEGACY PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-4285
Practice Address - Country:US
Practice Address - Phone:443-535-3649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501013822225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist